In general, fever is taken to mean a temperature greater than 38 ° C. Treatment of fever should be started after exceeding this value in children in whom high temperature causes discomfort and malaise. Therefore, there is no single arbitrarily adopted value above which antipyretic treatment is carried out.

The choice of the drug depends on the patient’s age, clinical situation and comorbidities. Ibuprofen, considered to be the stronger drug, should be used first.

Recommendations for the management of community-acquired respiratory tract infections recommend symptomatic treatment (analgesic and antipyretic: ibuprofen or paracetamol) as the basic therapy in children with an early stage of otitis media (in the first 24–48 hours) with pain. Although the recommendations indicate the use of a stronger anti-inflammatory drug (ibuprofen), but under the following condition: “as long as there are no contraindications”.

It is worth noting that in the light of meta-analyzes, NSAIDs do not show a beneficial anti-inflammatory effect in diseases of the upper respiratory tract, so in otitis, the focus should be on analgesic and antipyretic effects.