Digital PharmD

Informatics in Pharmacy

Otitis Media

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  • Analgesia: APAP, NSAIDS, rarely opioids. Avoid ASA in kids.
  • Antihistamines and decongestants are not usually recommended.
  • Antibiotics only if:
    • Bulging tympanic membrane, perforation or otorrhea
    • Delay unless fever or otalgia > 48-72 hours in kids > 2 years.
    • Not usually for otitis media with effusion, only if greater than 3 months
    • Not for the persistence of middle ear fluid.
  • Treatment doses:
    • Amoxil 80-90 mg/kg/day for 7-10 days
    • Azithromycin 10 mg/kg X 1 then 5mg/kg/day for 5 days.
  • Common pathogens:
    • Viral
    • S. pneumonia
    • H. influenzae
    • Moraxella catarrhalis
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