Otitis media

Acute

Recommended therapy (7 day duration)

Amoxicillin 500 mg PO TID

Penicillin allergic (rash)

Cefuroxime axetil 500 mg PO BID

Severe pen-allergy or cephalosporin allergy (e.g. anaphylaxis, angioedemia)

Clarithromycin 500 mg PO BID or TMP/SMX 1 DS tab PO BID

  • 80% of uncomplicated cases in previously healthy individuals usually resolve within 3 days.
  • S. pneumoniae susceptibility: Amoxicillin (98%), cefuroxime (92%), TMP/SMX (72%) & erythromycin (75%).

Complex or Chronic

Refer to BUGS & DRUGS OR Consult with Medical Microbiology / Infectious Disease and strongly consider an ENT consult.

  • Failure of First-line Agents
  • Persistent (greater than 7 days)
  • Chronic
  • Recurrences less than 6 weeks apart

Other Therapy Guidelines