amoxicillin is the recommended first-line antibiotic for acute otitis media (AOM) where antibiotics are indicated. Five days treatment at the following doses is sufficient for uncomplicated ear infections in children: antibiotic treatment (child) (2) amoxicillin for 5 days Neonate 7-28 days 30mg/kg TDS.
What are the treatment options for otitis media in infants and children?
In: Otitis Media in Infants and Children, 4th ed, BC Decker, Hamilton, ON 2007. p.213. Al-Shawwa BA, Wegner D. Trimethoprim-sulfamethoxazole plus topical antibiotics as therapy for acute otitis media with otorrhea caused by community-acquired methicillin-resistant Staphylococcus aureus in children.
Are antibiotics necessary for acute otitis media?
This article has been cited byother articles in PMC. Otitis media is the most common childhood infection for which antibiotics are prescribed. Nonetheless, there are a number of important questions about the optimal management of acute otitis media (AOM), and opinion is divided within the medical community on a range of fundamental issues.
How effective is amoxicillin for otitis media in children?
Despite theoretical concerns about the diminishing usefulness of amoxicillin, it continues to be as effective as any other oral antimicrobial agent for childhood AOM. In fact, it works as well as extended spectrum, penicillinase-resistant oral agents for otitis media caused by either penicillin-susceptible or -resistant bacteria (1).
What is the pathophysiology of acute otitis media?
Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Management of acute otitis media should begin with adequate analgesia.
Which antibiotic is the most appropriate for treatment of acute otitis media in a child with a rash from amoxicillin?
Type, frequency, and duration of antibiotics A US-based study reported amoxicillin-clavulanate (80 mg/kg per day for 10 days) to be more effective than cefdinir (14 mg/kg per day for 5 days) in treating 330 children 6 to 24 months of age with AOM.
What is the best treatment for acute otitis media?
TREATMENT OF ACUTE OTITIS MEDIA Antibiotics are the mainstay of treatment of uncomplicated acute otitis media (AOM) in adults, and initial antibiotic choice is determined by knowledge of the most common causative pathogens.
Which is the recommended first-line treatment for acute otitis media for an otherwise well child with no medication allergies?
High-dose amoxicillin is the recommended first-line treatment for children with AOM because of its efficacy and safety, low cost, palatability, and narrow microbiologic spectrum.
Which antibiotic has significantly greater efficacy for the treatment of otitis media in children?
From the present systematic review and meta-analysis, it can be concluded that the efficacy of azithromycin is comparable to amoxicillin/clavulanate, and it is safer and more tolerable by children. Azithromycin can, also be considered a drug of choice in treatment of otitis media on children.
How is otitis media treated in children?
Management of acute otitis media should begin with adequate analgesia. Antibiotic therapy can be deferred in children two years or older with mild symptoms. High-dose amoxicillin (80 to 90 mg per kg per day) is the antibiotic of choice for treating acute otitis media in patients who are not allergic to penicillin.
What is the first-line treatment for acute otitis media?
Amoxicillin at a dosage of 80 to 90 mg per kg per day should be the first-line antibiotic for most children with acute otitis media. Patients with otitis media who fail to respond to the initial treatment option within 48 to 72 hours should be reassessed to confirm the diagnosis.
What is the first-line agent for otitis media in pediatrics?
Amoxicillin at a dosage of 80 to 90 mg per kg per day should be the first-line antibiotic for most children with acute otitis media.
When should a child with otitis media be treated with antibiotics?
Antibiotics should be routinely prescribed for children with AOM who are six months or older with severe signs or symptoms (i.e., moderate or severe otalgia, otalgia for at least 48 hours, or temperature of 102.2°F [39°C] or higher), and for children younger than two years with bilateral AOM regardless of additional ...
Which of the following treatments is appropriate for a patient who has acute otitis media and has an allergy to penicillin?
Patients who are allergic to penicillin show 10-15% cross-reactivity when treated with cephalosporins. Levofloxacin has demonstrated higher efficacy in the treatment of AOM than amoxicillin-clavulanate has and can be used in patients who are allergic to penicillin.
What is the treatment of otitis media?
Chronic infection that results in a hole or tear in the eardrum — called chronic suppurative otitis media — is difficult to treat. It's often treated with antibiotics administered as drops. You may receive instructions on how to suction fluids out through the ear canal before administering drops.
Which of the following drugs would be administered for otitis media?
Antibiotic prophylaxis The most common regimens were sulfisoxazole (35 mg/kg once or twice daily) or amoxicillin (20 mg/kg once or twice daily). These therapies were usually administered in patients who had three or more episodes of AOM within a 6-month period or four or more episodes within 12 months.
Which is more effective azithromycin or amoxicillin?
Conclusions: In adults with acute sinusitis, a 3-day course of azithromycin was as effective and well tolerated as a 10-day course of amoxicillin/clavulanic acid. A significantly simpler dosage regimen and faster clinical effect were the advantages of azithromycin.
Practitioners’ Dilemma
Diagnosis
- Diagnostic criteria for AOM include: • acute symptom onset • signs and symptoms of middle ear inflammation • bulging tympanic membrane (TM) • decreased TM mobility • middle-ear effusion (MEE). In some cases, clinicians mistakenly diagnose AOM when the child doesn’t meet the criteria, or when the child actually has otitis media with effusion, not AOM. Some have doubts ab…
Treatment
- Because the evidence indicates AOM usually resolves spontaneously, practitioners should focus on providing adequate analgesia and limiting antibiotic use. Also, before prescribing antibiotics, they must strongly suspect bacteria are prevalent in the middle ear.
Parent Education
- Providing adequate parent (or other home caregiver) education is essential. Teach parents that the child should show clinical improvement in 48 to 72 hours after starting antibiotics— for instance, a temperature decrease if the child has a fever, reduced irritability and fussiness, and resumption of normal eating and drinking patterns. If no improvement occurs within that time, a…
Take Advantage of Well-Child Visits
- The well-child visit is an important opportunity to discuss how to prevent AOM and evaluate the child’s immunization schedule with parents. Strongly encourage an annual influenza vaccine for children older than 6 months as well as the pneumococcal conjugate vaccine, according to current immunization guidelines. Both vaccines drastically decrease AOM incidence and thus th…
Team Approach
- Sound clinical skills and judgment can play a role in the proper treatment of pediatric patients with AOM. In addition, studies indicate a team approach to treating AOM significantly reduces unnecessary antibiotic prescriptions. If you work in a healthcare provider group, advocate that the group adopt a practice guideline and reach a consensus to establish an antibiotic policy. The au…