Otitis Media

Question 1

Common pathogens of otitis media

Answer 1

S. pneumoniae, H. influenzae

Question 2

Uncommon pathogen of OM

Answer 2

M. catarrhalis

Question 3

OM signs and symptoms

Answer 3

Fluid in the middle ear, inflammation of mucosa of the middle ear, ear pain, ear drainage, hearing loss, fever, lethargy, irritability

Question 4

OM criteria

Answer 4

Middle ear diffusion plus moderate-severe bulging of tympanic membrane or new onset otorrhea OR

mild bulging of tympanic membrane AND onset of ear pain within the last 48 hours or intense erythema of tympanic membrane

Question 5

OM management

Answer 5

PCV, influenza vaccine

Question 6

When do you use ABX for OM?

Answer 6

6 months-12 years PLUS moderate-severe pain or temp 102.2ºF

6 months-23 months PLUS nonsevere bilateral acute OM

Question 7

Consider ABX for OM when…

Answer 7

6 months-23 months PLUS nonsevere unilateral pain

2-12 years PLUS acute, nonsevere acute OM

Question 8

OM ABX treatment

Answer 8

Amoxicillin 80-90mg/kg/day in 2 divided doses

Amox/clav 90mg/kg/day amox, 6.4mg/kg/day of clav in 2 divided doses

Try ceftriaxone 50mg IM or IV x3 days if Augmentin fails

Question 9

Pain management of OM

Answer 9

PO APAP or ibuprofen, otic ibuprofen for 5-12 years