Template:Otitis Media Antibiotics: Difference between revisions

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

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
Cefdinir 14mg/kg/day BID x7-10 days
Cefpodoxime 10mg/kg PO daily x7-10 days
Cefuroxime 15mg/kg PO BID x7-10 days
Cefprozil 15mg/kg PO BID x7-10 days

Otitis/Conjunctivitis

Suggestive of non-typeable H.flu

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

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

Penicillin Allergy

Azithromycin 10mg/kg/day x 1 day and 5mg/kg/day x 4 remaining days
Clarithromycin 7.5mg/kg PO BID x 10 days
Clindamycin 10mg/kg PO three times daily
- Clindamycin does not cover H. influenza and M. catarrhalis and treatment should favor Azithromycin use

Cephalexin 75-100mg/kg/day PO divided q12h x 10 days; Max: 4,000mg/24h

@@ Line 1: / Line 1: @@
-#'''[[Amoxicillin]] 80-90mg/kg/day divided into 2 daily doses x5-7days'''
+====Initial Treatment====
-#*1st line
+'''High Dose [[Amoxicillin]]'''
+{{OM amox peds treatment}}
+====Treatment during prior Month====
+# 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
+#{{AntibioticDose|disease=Acute otitis media|drug=Cefdinir|dose=14mg/kg/day BID x7-10 days|context=Prior Month Treatment|population=Pediatric}}
+#{{AntibioticDose|disease=Acute otitis media|drug=Cefpodoxime|dose=10mg/kg PO daily x7-10 days|context=Prior Month Treatment|population=Pediatric}}
+#{{AntibioticDose|disease=Acute otitis media|drug=Cefuroxime|dose=15mg/kg PO BID x7-10 days|context=Prior Month Treatment|population=Pediatric}}
+#{{AntibioticDose|disease=Acute otitis media|drug=Cefprozil|dose=15mg/kg PO BID x7-10 days|context=Prior Month Treatment|population=Pediatric}}
+====Otitis/Conjunctivitis====
+*Suggestive of non-typeable H.flu
 #'''[[Amoxicillin/Clavulanate]]'''
-#*80-90mg of amoxicillin per kg/day
+#*80-90mg of amoxicillin per kg/day PO divided BID x 7-10 days
-#*Consider if symptoms persist >72hr after amox begun
+#*Clavulanate increases vomiting/diarrhea
-#*Clavulanate increases vomiting/diarrhea
-#'''[[Azithromycin]]''' 10mg/kg/day x 1 day and 5mg/kg/day x 4 remaining days
+====Treatment Failure====
-#*Consider if penicillin allergic
+''defined as treatment during the prior 7-10 days''
-#'''[[Ceftriaxone]]''' 50mg/kg IM once as single injection
+#{{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}}
-#*Use if cannot tolerate PO
+#{{AntibioticDose|disease=Acute otitis media|drug=Ceftriaxone|dose=50mg/kg IM once as single injection x 3 days|context=Treatment Failure|population=Pediatric}}
-#'''[[Cefdinir]]''' 14mg/kg/day BID x 5 days
+#*Use if cannot tolerate PO
+====Penicillin Allergy====
+#{{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}}
+#{{AntibioticDose|disease=Acute otitis media|drug=Clarithromycin|dose=7.5mg/kg PO BID x 10 days|context=Penicillin Allergy|population=Pediatric}}
+#{{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
+*{{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}}