Sinusitis and OM meds Flashcards
Describe sinusitis
Secondary cold Viral rhinosinusitis (VRS)
What percent of Viral rhinosinusitis progresses to bacterial sinusitis?
1-2%
What causes bacterial growth in sinusitis? What does this result in?
Secondary obstruction
Acute bacterial sinusitis
What causes 50% of acute bacterial sinusitis?
S. pneumoniae
H. influenza
How quickly do VRS sx improve?
7-10 days
How do you clinically dx ABS?
Sx persistance > 10 days
Worsening sx in 5-7 days
OR
Transilummination of maxillary sinus
What is the rate of cure for ABS w/ 10 days if abx?
90%
What are some current abx recommendations for ABS?
Amoxicillin
Cefdinir
Levofloxacin
What is the MC reason for abx in kids?
Otitis media
What are the etiologies of AOM? How commonly?
S. pneumoniae (38%)
H. influenza (27%)
M. catarrhalis (10%)
How do you dx AOM?
Based of signs and sx
Inflammation of TM (red tympanic membrane)
Fluid in middle ear (bulging membrane)
What is a negative TM sx that isn’t AOM?
Retracted eardrum that is painful -> caused by negative middle ear pressure
Is a red TM w/o middle ear fluid AOM?
No
How do you inspect the TM?
W/ otoscope
When is tympanocentesis indicated?
Pt critically ill @ sx onset
Toxic pts not responding in 48-72 hours
Pts w/ altered host defenses
