Template:Otitis Media Antibiotics: Difference between revisions
(Add Cephalexin pediatric AntibioticDose entry)
 
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# If amoxicillin taken in past 30 days, '''[[Amoxicillin/Clavulanate]]'''
# If amoxicillin taken in past 30 days, '''[[Amoxicillin/Clavulanate]]'''
#*80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
#*80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
#*Clavulanate increases vomiting/diarrhea  
#*Clavulanate increases vomiting/diarrhea
#'''[[Cefdinir]]''' 14mg/kg/day BID x7-10 days
#{{AntibioticDose|disease=Acute otitis media|drug=Cefdinir|dose=14mg/kg/day BID x7-10 days|context=Prior Month Treatment|population=Pediatric}}
#'''[[Cefpodoxime]]''' 10mg/kg PO daily x7-10 days
#{{AntibioticDose|disease=Acute otitis media|drug=Cefpodoxime|dose=10mg/kg PO daily x7-10 days|context=Prior Month Treatment|population=Pediatric}}
#'''[[Cefuroxime]]''' 15mg/kg PO BID x7-10 days
#{{AntibioticDose|disease=Acute otitis media|drug=Cefuroxime|dose=15mg/kg PO BID x7-10 days|context=Prior Month Treatment|population=Pediatric}}
#'''[[Cefprozil]]''' 15mg/kg PO BID x7-10 days
#{{AntibioticDose|disease=Acute otitis media|drug=Cefprozil|dose=15mg/kg PO BID x7-10 days|context=Prior Month Treatment|population=Pediatric}}


====Otitis/Conjunctivitis====
====Otitis/Conjunctivitis====
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#'''[[Amoxicillin/Clavulanate]]'''
#'''[[Amoxicillin/Clavulanate]]'''
#*80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
#*80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
#*Clavulanate increases vomiting/diarrhea  
#*Clavulanate increases vomiting/diarrhea


====Treatment Failure====
====Treatment Failure====
''defined as treatment during the prior 7-10 days''
''defined as treatment during the prior 7-10 days''
#'''[[Amoxicillin/Clavulanate]]'''
#{{AntibioticDose|disease=Acute otitis media|drug=Amoxicillin/Clavulanate|dose=80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days|context=Treatment Failure|population=Pediatric}}
#*80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
#{{AntibioticDose|disease=Acute otitis media|drug=Ceftriaxone|dose=50mg/kg IM once as single injection x 3 days|context=Treatment Failure|population=Pediatric}}
#'''[[Ceftriaxone]]''' 50mg/kg IM once as single injection x 3 days
#*Use if cannot tolerate PO
#*Use if cannot tolerate PO


====Penicillin Allergy====
====Penicillin Allergy====
#'''[[Azithromycin]]''' 10mg/kg/day x 1 day and 5mg/kg/day x 4 remaining days
#{{AntibioticDose|disease=Acute otitis media|drug=Azithromycin|dose=10mg/kg/day x 1 day and 5mg/kg/day x 4 remaining days|context=Penicillin Allergy|population=Pediatric}}
#'''[[Clarithromycin]]''' 7.5mg/kg PO BID x 10 days
#{{AntibioticDose|disease=Acute otitis media|drug=Clarithromycin|dose=7.5mg/kg PO BID x 10 days|context=Penicillin Allergy|population=Pediatric}}
#'''[[Clindamycin]]''' 10mg/kg PO three times daily
#{{AntibioticDose|disease=Acute otitis media|drug=Clindamycin|dose=10mg/kg PO three times daily|context=Penicillin Allergy|population=Pediatric}}
#*Clindamycin does not cover [[H. influenza]] and [[M. catarrhalis]] and treatment should favor Azithromycin use
#*Clindamycin does not cover [[H. influenza]] and [[M. catarrhalis]] and treatment should favor Azithromycin use
*{{AntibioticDose|drug=Cephalexin|dose=75-100mg/kg/day PO divided q12h x 10 days; Max: 4,000mg/24h|context=Otitis Media|disease=Acute otitis media|population=Pediatric}}

Latest revision as of 10:51, 20 March 2026

Initial Treatment

High Dose Amoxicillin

  • <2 months
    • Amoxicillin 30mg/kg/day PO divided q12h x 10 days
    • First Dose: 15mg/kg PO x 1
  • 2 months - 5 years
    • Amoxicillin 80-90mg/kg/day PO divided q12h x 10 days
    • First Dose: 40-45mg/kg PO x 1
    • Max: 1000mg/dose
  • 6-12 years
    • Amoxicillin 80-90mg/kg/day PO divided q12h x 5-10 days
    • First Dose: 40-45mg/kg/day PO x 1
    • Max: 1000mg/dose

Treatment during prior Month

  1. If amoxicillin taken in past 30 days, Amoxicillin/Clavulanate
    • 80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
    • Clavulanate increases vomiting/diarrhea
  2. Cefdinir 14mg/kg/day BID x7-10 days
  3. Cefpodoxime 10mg/kg PO daily x7-10 days
  4. Cefuroxime 15mg/kg PO BID x7-10 days
  5. Cefprozil 15mg/kg PO BID x7-10 days

Otitis/Conjunctivitis

  • Suggestive of non-typeable H.flu
  1. Amoxicillin/Clavulanate
    • 80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
    • Clavulanate increases vomiting/diarrhea

Treatment Failure

defined as treatment during the prior 7-10 days

  1. Amoxicillin/Clavulanate 80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
  2. Ceftriaxone 50mg/kg IM once as single injection x 3 days
    • Use if cannot tolerate PO

Penicillin Allergy

  1. Azithromycin 10mg/kg/day x 1 day and 5mg/kg/day x 4 remaining days
  2. Clarithromycin 7.5mg/kg PO BID x 10 days
  3. Clindamycin 10mg/kg PO three times daily
  • Cephalexin 75-100mg/kg/day PO divided q12h x 10 days; Max: 4,000mg/24h
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