OIA1015 EENT INFECTION MANAGEMENT

Acute Otitis Media (AOM)

Acute Otitis Media (AOM)

Otitis Media with Effusion (OME)

Fluid in middle ear without inflammation; not painful like AOM.

Chronic Suppurative OM

Persistent drainage through perforated tympanic membrane >2–6 weeks.

Why children are prone to AOM

Shorter, more horizontal Eustachian tubes + immature immune systems.

Common pathogens in AOM (children)

S. pneumoniae, H. influenzae, M. catarrhalis.

Common pathogens in chronic OM

S. aureus, P. aeruginosa, K. pneumoniae.

Risk factors for OM

Age <2, male sex, pacifier use, bottle feeding, daycare, smoke exposure, cleft palate.

Key AOM symptoms in infants

Irritability, ear tugging, fussiness, fever.

Key AOM symptoms in older children

Unilateral otalgia, pressure, decreased hearing, dizziness, diarrhea.

Diagnosis of AOM

Otoscopic exam (bulging, red tympanic membrane); consider aspiration for C&S.

Observation first-line in AOM

Monitor for 48–72 hrs; if no improvement or severe bilateral symptoms, start antibiotics.

Antibiotic Indications (AOM)

Age >6 months with severe symptoms; <24 months with non-severe bilateral AOM.

First-line antibiotic (AOM)

High-dose amoxicillin.

Alternative antibiotics (AOM)

Amoxicillin/clavulanate (Augmentin®), 2nd/3rd gen cephalosporins.

If penicillin allergy (AOM)

Macrolides (e.g., azithromycin), or clindamycin.

Supportive therapy for AOM

Paracetamol (10–15 mg/kg) or ibuprofen (5–10 mg/kg) for pain/fever.

Adjunct medications (AOM)

Decongestants, antihistamines, mucolytics for congestion or sneezing.

Monitoring parameters (AOM)

Track fever, ear pain, improvement; monitor for antibiotic side effects.

Counseling for parents (AOM)

Avoid smoke exposure, ensure vaccination (pneumococcal/influenza), complete full antibiotic course.

Pharmacist’s role in AOM

Advise on rational antibiotic use, non-prescription analgesics, reinforce vaccine importance.

Definition (Pharyngitis & Tonsillitis)

Inflammation of the pharynx/tonsils, typically infectious; major cause of sore throat.

Common causes (Pharyngitis & Tonsillitis)

90–95% viral (cold, flu, coxsackie); 5–10% bacterial (Group A Streptococcus).

Other irritants (Pharyngitis & Tonsillitis)

Smoke, dust, pollution may also trigger sore throat.

Key symptoms (Pharyngitis & Tonsillitis)

Sore throat, hoarseness, fever, blisters in mouth, painful swallowing.

Viral sore throat hallmark

Cold symptoms, conjunctivitis, blisters — resolves in 7–10 days without antibiotics.

When to refer for sore throat

3 weeks duration, severe pain, otalgia, dysphagia, immunocompromised.

Centor & FeverPAIN scoring

Clinical tools to identify likelihood of streptococcal infection.

Score interpretation (NICE 2018)

Score 0–1: Low risk; Score ≥2: Consider antibiotics if no improvement after 3–5 days.

Sore throat management

Analgesics (paracetamol/NSAIDs), single-dose prednisolone, local lozenges.

Non-pharmacologic sore throat care

Warm salt gargle, soft foods, fluids, avoid acidic juices/smoking, adequate rest.

Hygiene strategies

Handwashing, avoid close contact, don't share utensils or food, avoid smoke/pollution.

Conjunctivitis definition

Inflammation of conjunctiva; presents with “red eye,” irritation, discharge.

Types of conjunctivitis

Viral (most common), bacterial, allergic, or mechanical.

Bacterial conjunctivitis signs

Mucopurulent discharge, “glued shut” eyes in the morning.

Common bacterial organisms (Conjunctivitis)

N. gonorrhoeae, S. aureus, S. pneumoniae, H. influenzae.

Viral conjunctivitis signs

Watery discharge, itchy red eyes; highly contagious; often from adenovirus or HSV.

Gonococcal conjunctivitis

Serious; may cause blindness; treat with IV ceftriaxone + oral azithromycin; refer urgently.

Non-gonococcal treatment

Topical antibiotics (e.g. chloramphenicol) x 5–7 days; refer if symptoms persist >4 weeks.

Patient education for conjunctivitis

Avoid touching eyes, no sharing towels/makeup, complete prescribed course, discard used eye drops.

Supportive measures (Conjunctivitis)

Cool compress, artificial tears, hygiene reinforcement; avoid makeup testers or shared items.