Management aimed at treating acute otitis media
Acetaminophen/ibuprofen and topical benzocaine (unless perforated TM)
^Fever > 39C or severe otalgia <48 hrs
Also Consider In:
Age <6mo
Ill-appearing
Recurrent acute otitis media (within 2-4wk)
Concurrent antibiotic treatment
Other bacterial infections
Immunocompromised
Craniofacial abnormalities
Rather that routine prescription is an option to avoid over use if the patient does not meet any of the prescription criteria
If symptoms worsen or persist for 48-72 then caretaker fill the prescription
Fever (relative risk [RR], 2.95; 95% confidence interval [CI], 1.75 - 4.99; P<.001) and otalgia (RR, 1.62; 95% CI, 1.26 - 2.03; P<.001) were associated with filling the prescription in the WASP group
Consider treating for a standard of 10 days as opposed to a shorter duration of 5 days to reduce treatment failure in young children
Treatment failure for 10 day at 16% and for 5 day at 34% for amoxicillin-clavulanate
RTC of 520 children aged 6-23 months
Treatment failure for 10 day at 16% and for 5 day at 34% for amoxicillin-clavulanate
RTC of 520 children aged 6-23 months
80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
Clavulanate increases vomiting/diarrhea
Suggestive of non-typeable H.flu
80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
Clavulanate increases vomiting/diarrhea
defined as treatment during the prior 7-10 days
80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
Use if cannot tolerate PO
Clindamycin does not cover H. influenza and M. catarrhalis and treatment should favor Azithromycin use
Bullous myringitis
Auricular hematoma
Peritonsillar cellulitis
Auricular perichondritis
Ludwig's angina
Cholesteatoma
Streptococcal pharyngitis
Contact dermatitis