Acute otitis Media

When do most Acute otitis Media symptoms resolve

80% resolved by day 7

(sx; 3-10 days)

T/F You need to have a middle ear effusion to be diagnosed, but having one doesn't mean they have an ear infection

true

Non severe AOM:

For unilater and bolateral respectively, who gets observation and who gets antimicrobial therapy?

Unilateral:

-Observation for 6 mo+

Bilateral:

-Antibiotics for 6-23 mo

-Observation 2 yo and up

Severe AOM or Otorrhea w/AOM:

For unilater and bolateral respectively, who gets observation and who gets antimicrobial therapy?

Unilateral:

-Antibiotics for 6 mo+

Bilateral:

-Antibiotics for 6 mo+

Who gets 10 day antibiotic duration?

All severe AOM cases
All children w/AOM <24 months of age

Who gets 7 day antibiotic duration?

Mild to moderate AOM in children 2-5 years

Who gets 5-7 day antibiotic duration?

Mild to moderate AOM in children 6 years and older

Who gets Amoxicillin as initial treamtent?

• have not received amox in last 30 days

• does not have concurrent purulent conjunctivitis

• is not allergic to penicillin

Who gets Amox/Clav as initial treamtent?

• has received amox in last 30 days

• has concurrent purulent conjunctivitis

• has h/o recurrent AOM unresponsible to amoxicillin

Treatment options for patients with Mild non-IGE mediated penicillin allergy

PO: Cefdinir, cefpodoxime, cefuroxime

or

IM ceftriaxone

Treatment options for patients with immediate rxn penicillin allergy

• Azithromycin

• clarithromycin

• clindamycin

if initial observation failed →

treat with antimicrobials

if initial antibtiotic failed →

choose alternative therapy

amox→ amox/clav

amox/clav→ ceftriaxone