Acute Otitis Media

Pt with personal and family h/o otitis media presents with acute onset ear pain. Parents report fever, irritability, poor feeding, and pulling/tugging/rubbing of the ear. Attends daycare; parents smoke at home. Bulging, erythematous/cloudy tympanic membrane with air-fluid level on exam.

  • Tylenol/Motrin for pain

  • Amoxicillin 80 mg/kg/day divided every 12 hours x

    • 10 days in children < 2 y/o

    • 7 days children > 2 y/o

  • Refer for tympanostomy tube placement for either of the following:

    • 3 or more episodes in the past 6 months

    • 4 or more episodes in the past year

  • Parents advised that

    • 80% of cases resolve within 3 days without antibiotics

    • Antibiotics increase risk of vomiting, diarrhea, rash

Note: No treatment and follow-up in 3 months is recommended for otitis media with effusion