Drugs & Doses: ENT

Question 1

Otitis Media

Answer 1

1. Amoxycillin 15mg/kg TDS x 5 days (if indicated) or 30mg/kg BD
2. THEN - Augmentin (amoxycillin + clavulanate) 22.5+3.2mg/kg BD x 5 days - if not improving
3. PLUS - cipro 0.3% drops - 5 drops Q12H until no d/c for 3/7 if chronic otorrhea present

ATSI

1. OM - PO Abs for at least 7/7, increase to 14/7 if TM still bulging
2. OM with perf - Amox for 14/7, if persistent, change to Augmentin for another 2-4 weeks

Question 2

Otitis Externa

Answer 2

1. Dex / framycetin / gramicidin (Otodex / Sofradex) drops for 7/7
2. If perf’d TM - cipro + dex drops
3. Drying (long term mx) - acetic acid + isopropyl alcohol drops

Question 3

Menieres disease

Answer 3

1. HCTZ 25-50mg daily +/- amiloride OR triamterene

2. Low salt diet <3g salt and avoid caffeine

Question 4

Croup

Answer 4

Prednisolone 1mg/kg oral, may have 2nd dose 24 hrs later if needed

Question 5

Epiglottitis

Answer 5

1. Ceftriaxone 1 g (child 1 month or older: 50 mg/kg up to 1 g) IV, daily for 5 days
2. PLUS prophylaxis for pt + close contacts (rifampicin for HiB clearance)

Question 6

Strep tonsillitis/Scarlet fever

Answer 6

1. Phenoxymethylpenicillin 500mg (kids 15mg/kg) oral, 12 hrly x 10 days
2. OR single dose IM benzathine benzylpenicillin

Question 7

Dacrocystitis

Answer 7

Cephalexin 500mg Q6H

Question 8

Sinusitis

Answer 8

1. Amoxicillin 500mg Q8H for 5/7 If allergy - Doxy 100mg Q12H for 5/7
2. IN corticosteroid (budesonide), IN decongestant, IN ipratropium if rhinorrhoea ++

Question 9

Vestibular neuronitis

Answer 9

Pred 1mg/kg (max 75mg) for 5/7, taper dose over 2/52 and cease

Question 10

Parotitis

Answer 10

Fluclox 500mg Q6H for 10/7. If allergic, clindamycin 450mg Q8H for 10/7