7.4 Otitis media
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Acute otitis media: If the patient has recent onset of ear pain/ erythema of the tympanic membrane | Mostly viral- antibiotics not indicated | Treat children < 2 years. If >2 years, afebrile and no ear pain- consider analgesics and defer antibiotics. Pain assessment and relief by using analgesics. | |
| Severe: Temperature39 0C or higher ORsevere otalgia ORotalgia persisting formore than 48 hoursor bulging tympanicmembrane orcomplication likemastoiditis orabscess | Amoxicillin- clavulanate 90/6.4mg /kg/day BID for 5-7 days |
Cefuroxime axetil 250mg BD for 5-7 days Or Piperacillin- tazobactam 4.5g IV 8h or Cefepime or Ceftazidime 2g IV OD and Metronidazole (in immunocompromised or intracranial extension/ diabetes mellitus) |
For common etiological agents of Otitis media, see Annexure B.7.4