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.
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