Acute Otitis Media

Question 1

What is this a presentation of?

Young child, rapid onset pain, fever, irritability. Red inflamed tympanic membrane. Anorexia, vomiting, recent URTI.

Answer 1

Acute otitis media

Question 2

What are the risk factors for acute otitis media?

Answer 2

Young child, winter, URTI, bottle feeding, passive smoking, asthma, cleft palate, GORD.

Question 3

What is the initial management for acute otitis media?

Answer 3

Optimise analgesia, 60% resolve within 24 hours without antibiotics.

Question 4

What are the indications to start antibiotics in acute otitis media?

Answer 4

1. Systemically unwell
2. Immunocompromised
3. Symptoms lasting more than 4 days
4. Perforation/discharge
5. <2 years with bilateral otitis media

Question 5

Which antibiotics are used for acute otitis media?

Answer 5

5 days of PO Amoxicillin (erythromycin if allergic)