Template:Otitis Media Antibiotics

Initial Treatment

Treatment is targeted at S. pneumoniae, H. influenzae, Moraxella catarrhalis, S. pyogenes, S. aureus, and Rhinovirus

1. Amoxicillin 80-90mg/kg/day divided into 2 daily doses 7-10 days

Treatment during prior Month

1. Can use Amoxicillin as same dosing as initial treatment
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

Treatment Failure

defined as treatment during the prior 7-10 days

1. Amoxicillin/Clavulanate
   • 80-90mg of amoxicillin per kg/day
   • Clavulanate increases vomiting/diarrhea
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
   • Clindamycin does not cover H. influenza and M. catarrhalis and treatment should favor Azithromycin use