Otitis media and externa

Infection of middle ear

acute otitis media

Three most common pathogens causing AOM

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.

Most common bacterial cause of AOM

Streptococcus pneumoniae

Common symptoms of AOM

4

Ear pain

fever

bulging tm

decreased hearing

Most important physical exam finding for AOM

Bulging tympanic membrane

First step in managing AOM pain

tylenol or motrin

should antibiotics replace pain medication with AOM

no

First line antibiotic for AOM

high-dose amoxicillin (80-90mg/kg/day)

Beta-lactam that inhibits bacterial cell wall synthesis

Amoxicillin

Common side effects of amoxicillin

3

diarrhea

rash

nausea

contraindication to amoxicillin

penicillin allergy

When should Augmentin be used instead of amox

3

amox used within 30 days, recurrent AOM, purulent conjunctivitis

Why is clavulanate added

inhibits beta-lactamase

Alternative treatment for non-severe penicillin allergy

Cefdinir

Alternative med for severe penicillin allergy

Azithromycin

Infection of the external ear canal

otitis externa

Hallmark symptom of otitis externa

pain with movement of pinna or tragus

Sx of swimmers ear

3

ear canal swelling

itching

drainage

first line treatment for uncomplicated OE

antibiotic ear drps (ciprodex)

what med is a Fluoroquinolone- blocks bacterial dna gyrase

ciprofloxacin

purpose of dexamethasone in ciprodex

reduces inflammation and pain

side effects of otic fluoroquinolones

2

mild irritation

itching

contraindication to ciprofloxacin

allergy to fluoroquinolones

if the ear canal is severely swollen, what should be done with OE

insert ear wick

If the patient has tympanostomy tubes or a perforated TM, which drops are safest

ofloxacin

Which ear drops should be avoided with a perforated TM

Neomycin containing drops