AOM

Question 1

microbiology of AOM

Answer 1

S. pneumoniae
H. influenzae
M. catarrhalis

Question 2

diagnosis of AOM

Answer 2

acute onset < 48h
othalgia/erythema of tympanic membrane
bulging of tympanic membrane

Question 3

observation period requirements for AOM

Answer 3

ALL of:
≥ 6m
non-severe illness (better than moderate-severe otalgia, otalgia < 48h, no fever)
no otorrhea
possible for close follow up
shared decision making with parent/caregiver

Question 4

requirements for amoxicillin for AOM treatment

Answer 4

no amoxicillin treatment in past 30d
no concurrent purulent conjunctivitis
no penicillin allergy

Question 5

indications for amoxicillin/clavulanate in AOM

Answer 5

previous amoxicillin usage in past 30d
concurrent purulent conjunctivitis
history of failed AOM treatment with amoxicillin

Question 6

1st line treatment in AOM

Answer 6

amoxicillin PO 80-90mg/kg/day divided BD

amoxicillin/clavulanate PO 80-90mg/kg/d divided BD

Question 7

alternative treatment in AOM

Answer 7

cefuroxime PO 30mg/kg/d divided BD

clindamycin PO 7mg/kg TDS (?) (severe penicillin allergy)

Question 8

clinical improvement, duration of treatment in AOM

Answer 8

48-72h 
< 2y: 10d
severe: 10d
2-5y, non-severe: 7d 
> 5y, non severe: 5d

Question 9

clinical presentation of AOM

Answer 9

otalgia 
otorrhea
ear popping 
ear fullness
hearing impairment 
dizziness 
fever