Pediatric infectious Disease: Otis Media

Question 1

T/F: Otitis Media is the most common indication for antibiotics in children

Answer 1

True

Question 2

Why has there been a decrease in prevelance in acute Otitis Media

Answer 2

The pneumococcal vaccine (PCV13)

Question 3

What are the risks for antibiotic resistance

Answer 3

Increased use of antibiotics, less than two years old, winter climate, high attendance at daycare, recent antibiotic use

Question 4

What significant symptoms are present in an ear infection

Answer 4

Temperature, increased heart rate, bulging tempanic membrane with little movement, hearing impatirement, discharge/tympanostomy tubes placed

Question 5

Why are kids at a higher risk of getting ear infections

Answer 5

Since they have Eustachian that is at a flat angle not allowing for good drainage

Question 6

How can not feeding bottles at an angle lead to an ear infection

Answer 6

Formula can be backwashed and stuck in the Eustachian tube

Question 7

T/F: A cleft palate mutation can increase risk of ear infections

Answer 7

True

Question 8

What are enviornmental causes of earinfections

Answer 8

Day care attendance, smoking, respiratory infections

Question 9

Whats the purpose of treating otis media

Answer 9

reduce hearing impairment, mastoditis

Question 10

T/F When a child has ear pain the best resolution is always with an antibiotic

Answer 10

False: 80% of the time there is a resolution without. Antibiotics are only needed if an infection is present

Question 11

What organisms cause acute otitis media

Answer 11

Streptococcus Pneumoniae, Moraxella Catarrhalis, Haemophilus influenza, Staphylococcus Aureus

Question 12

What are the most common causes of acute otitis media, what helps combat this cause

Answer 12

Viruses, Flu and PCV13 vaccinations

Question 13

When symptoms constitute a severe acute otitis media

Answer 13

Moderate or severe ear pain with a fever greater than 102.2

Question 14

What medications should be given within the first 24 hours if possible, which is better

Answer 14

Acetaminophen or Ibuprofen, Acetaminophen

Question 15

What is the 1st line treatment option for acute otitis media

Answer 15

Observation (deter antibiotic treatment for 48 to 72 hours with follow up

Question 16

When would observation not be a viable option

Answer 16

Patient has an infection in both ears, patient is less than 6 months old, severe illness

Question 17

When would observation be a viable option

Answer 17

If the patient is inbetween 6 months and 2 yeards old with non-severe illness and unilateral involment, greater than 2 with a non-severe illness and no ear pain

Question 18

T/F: Cephlasporins is not an effective choice for AOM therapy and Erythromycin does treat AOM but is not effective against resistant strands because they don’t reach adequate concentrations

Answer 18

False: Erythromycin is not an effective choice for AOM therapy and Cephalosporins do treat AOM but many are not effective against resistant organisms because they don’t reach adequate concentrations

Question 19

What is the first line antibiotic therapy for non-severe Acute Otitis Media, what dose

Answer 19

Amoxicillin 80-90 mg/kg/day

Question 20

What antibiotic is given if the patient fails Amoxicillin, what dose

Answer 20

Augmentin 80-90 mg/kg/day

Question 21

T/F: If the patient has a type 1 allergy (anaphylaxis, hives, SOB) the paitent can only be moved to cefuroxine or cefdnir, while a Type 2 allergy could keep them on Amoxicillin or Augmentin

Answer 21

True

Question 22

What antibioitc would be given if a patient failed Augmentin

Answer 22

Ceftriaxone, Tympamocentesis, Clindamycin

Question 23

What is 1st line antibiotics if the patient has a severe acute Otitis Media, what is the dose

Answer 23

Augmentin 80-90 mg/kg/day

Question 24

What antibiotic therapy is given if the patient fails Augmentin 80-90 mg/kg/day

Answer 24

Ceftriaxone IM daily for 3 days or Cefdnir given once or twice a day/Cefuroxime given twice a day

Question 25

How long should the oral antibiotics be for a patient who is less than two years old or has severe AOM, 2-5 years old with Mild-moderate AOM, greater than 6 years old with mild-moderate AOM

Answer 25

10 days, 7 days, 5-7 days

Question 26

T/F: Bactrim can be given prophetically to prevent AOM

Answer 26

False: AOM does not warrant any prophylactics

Question 27

What is recurrent AOM

Answer 27

Greater than 3 infections in 6 monts or greater than 4 in one year with one infection having occured in the past 6 months

Question 28

What are ways to decrease risk for getting AOM

Answer 28

Lower child care attendance, implement breast feeding the 1st 6 months, avoid supine bottle feeding, reduce pacifier use in 2nd 6 months, eliminate 2nd hand smoke, vaccinate

Question 29

What medication classes are not recommended

Answer 29

Decongestants, antihistamines, xylitol

Question 30

T/F: Swimmmer’s ear doesn’t need antibiotics

Answer 30

True