Not Another Fever

Question 1

AOM most prevalent ages

Answer 1

6 mo - 2yr

Question 2

AOM most common pathogens

Answer 2

Strep pneumo
H. flu
Moraxella

Resp viruses

Question 3

AOM non-modifiable risk factor

Answer 3

Age
Genetic susceptibility
Family history
Craniofacial abnormalities (cleft palate, T21)
Other kids in household
Recent viral infection
Low socioeconomic status

Question 4

AOM Potentially modifiable risk factors

Answer 4

Day care settings
pacifier
bottle propping
passive tobacco exposure
Breastfeeding <6 mo
flu infection
pneumococcal infxn

Question 5

Treat AOM

Answer 5

otorrhea
severe symptoms (uni/bilateral)
bilateral no otorrhea <2yr

Question 6

Consider Observe AOM (48-72hr)

Answer 6

Bilat w/o otorrhea >=2yr

Uni w/o otorrhea all infants & kids

Question 7

AOM 1st line

Answer 7

Amox 90 mg/kg/day div Q12h

Question 8

AOM tx if conjunctivitis or recieved amox in last 30 days

Answer 8

Augmentin (14:1) div Q12h
90mg/kg amox
6.4 mg/kg clav

Question 9

AOM tx pcn allergy

Answer 9

Cefdinir (3), cefpodoxime, (3) cefuroxime (2)

ceftriaxone 50 mg/kg QD x 3 days

Question 10

AOM tx duration

Answer 10

<2 yr: 10 days
2-5 yr: 7 days
>5 yr: 5-7 days

Question 11

2nd line AOM tx

Answer 11

Augmentin
or
CTX

Alt - Clinda (30-40mg/ kg/d div 3 doses) +/- 3rd gen ceph

Question 12

Failed second abx

Answer 12

Clinda +/- 3rd gen ceph

typanocentesis

consult ENT