Acute Otitis Media (AOM)

Question 1

Presentation of AOM

Answer 1

typically ear pain (otalgia) and behavioral changes (esp in children and elderly)

Question 2

Etiology of AOM

Answer 2

• S. pneumonia [gram + aerobe] ( most common)
• H. influenzae [gram - aerobe]
• M. catarrhalis [gram - anaerobe] ( least common)

Question 3

Risk factors for AOM

Answer 3

• Children (shorter, less vertical eustachian tubes)

Question 4

Risk factors for Amoxil resistance:

Answer 4

• Child care center attendance
• Antibiotic use in the last 30 days
• Age < 2 yrs

Question 5

When to NOT delay therapy:

Answer 5

• < 6 months
• 6-24 months w/ severe sxs or definitive diagnosis
• > 2 yrs w/ both severe sxs & definitive diagnosis

Question 6

Treatment of AOM

Answer 6

Amoxil 40-45mg/kg BID for most patients (80-90mg/kg/day)

Question 7

Criteria for treatment with Augmentin

Answer 7

• Severe infection (severe otalgia and/or temp > 102 degrees fahrenheit)
• failure of amoxil at 48-72 hours
• suspected or known beta-lactamase producing organism
  (you still want 90mg/kg/day of amoxil component)

Question 8

Duration of therapy

Answer 8

• traditionally 10 days

- 5-7 days may be reasonable for patients > 6 yrs w/ mild-moderate symptoms