OBJECTIVE The aim of this study was to evaluate the effectiveness of nasal decongestants, oral decongestants and oral decongestant-antihistamines in the treatment of acute otitis media and resolution of the middle ear effusion in children. METHODS 355 ears of 318 children [160 boys (179 ears) and 158 girls (176 ears)] who were diagnosed to have acute otitis media and treated for it with different drug regimens were evaluated retrospectively regarding resolution of the middle ear fluid. 151 ears were treated with antibiotics and analgesics (group 1), 64 with antibiotics, topical decongestants and analgesics (group 2), 81 with antibiotics, oral decongestants and analgesics (group 3), and 59 with antibiotics, oral decongestant-antihistamine combinations and analgesics (group 4). The children with middle ear effusion were followed up for three months. RESULTS Group 1, 2, 3 and 4 had persistent middle ear effusion and the presence of middle ear effusion was 27.2%, 18.8%, 25.9%, 28.8% at the 1st month and 5.8%, 0%, 0% and 5.9% at the end of the 3rd month, respectively. At the end of the 3rd month, there was no significant difference between the groups regarding the resolution rates of the middle ear fluids in the antibiotic group and decongestants groups (p>0.05). CONCLUSIONS We do not recommend the use of decongestants and antihistamines in the treatment of acute otitis media as they do not change the natural course of the disease.