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Second Chance - Acute Otitis Media

Non-severe treatment for AOM?
Amoxicillin (high dose) 80-90 mg/kg/day in 2 divided doses
Severe tx for AOM?
Amoxicillin-clavulanate (high dose) 90mg/kg/day + 6.4 mg/kg/day of clavulnate in 2 divided doses
What qualifies for severe AOM?
Amoxicillin last 30 days
Purulent conjunctivitis
Hx of recurrent AOM, no response to amoxicillin
Idiopathic PCN rxn if severe?
€¢ Ceftriaxone 50 mg/kg IM or IV per day (for 1 or 3 days)
Idiopathic PCN rxn if not severe?
Cefdinir 14 mg/kg/day (in 1 or 2 doses)
Type 1 rxn to PCN
Azithromycin 10 mg/kg x day 1, then 5 mg/kg x days 2-5
Otalgia tx?
APAP 10-15mg/kg q 4-6hrs PRN, max 3-4g
Ibuprofen 5-10mg/kg q 6-8hrs PRN max 1200mg
Acute bacterial rhinosinusitis qualification?
Sx resolution <4 wks
3 or more eps per year
How to dx acute bacterial rhinosinusitis?
Nasal discharge and/or daytime cough for 10 or more days w/o improving
Tx for child with acute bacterial rhinosinusitis?
Amox-clav 45mg/kg/day PO BID
Amox-clav 90mg/kg/day PO BID
Tx for child with acute bacterial rhinosinusitis with risk factors?
Amox-clav 45mg/kg/day PO BID
Amox-clav 90mg/kg/day PO BID
Tx for adult with acute bacterial rhinosinusitis?
Amox-clav 500-125mg PO TID
Levoflox 500mg QD
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