Otitis media, acute

H66.9

DESCRIPTION

Inflammation of the middle ear of rapid onset.

MEDICINE TREATMENT

In previously untreated patients:

  • Amoxicillin, oral, 100 mg 8 hourly for 5 days

LoEIII [8]

Patients not responding to amoxicillin:

  • Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly for 5 days

LoEIII [9]

Severe penicillin allergy: (Z88.0)

  • Macrolide, e.g.:
    • Azithromycin, oral, 500 mg daily for 3 days

For patients with upper respiratory tract congestion, secondary to allergy: (T78.4)

  • Non-sedating antihistamine, oral, e.g.:
  • Cetirizine, oral, 10 mg daily for 10 days.

LoEII [10]

For management of allergic rhinitis, see Rhinitis, allergic, persistent.

For pain:

  • Paracetamol, oral, 1 g 4–6 hourly when required.
    • Maximum dose: 15 mg/kg/dose.
    • Maximum daily dose: 4 g in 24 hours.

LoEIII [11]

If pain is not controlled, see Pain.

REFERRAL

  • No response to amoxicillin/clavulanic acid.
  • No pain relief despite treatment.
  • Bulging eardrum, not responding to treatment after 24 hours.
  • Swelling and pain on palpation of the mastoid process.
  • Recurrent otitis media.