A recent Cochrane review looked at the role of antibiotics in helping children with glue ear. The review found evidence of both benefits and harms associated with the use of antibiotics. In many cases it is not necessary to treat a child simply because the glue is present. But if its presence is having an adverse effect on the child, action may be necessary. But even this decision is not straightforward, because we know that the condition fluctuates, and can resolve on its own – without any help from anyone – in a significant proportion of children. This is why so-called ‘active monitoring’ or ‘watchful waiting’ may be the best approach.