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Acute otitis media: part II. Treatment in an era of increasing antibiotic resistance

M E Pichichero1

  • 1University of Rochester Medical Center, New York, USA.

American Family Physician
|May 4, 2000
PubMed

Insights

Antibiotic resistance in acute otitis media (AOM) necessitates treatment changes. Higher amoxicillin doses and shorter courses improve outcomes for this common childhood infection.

Area of Science:

  • Infectious Diseases
  • Pediatrics
  • Pharmacology

Background:

  • Increasing antibiotic resistance in pathogens causing acute otitis media (AOM) challenges traditional treatment protocols.
  • Risk factors for resistant AOM pathogens include prior antibiotic use, daycare attendance, and young age.

Purpose of the Study:

  • To review current antibiotic resistance trends in AOM pathogens.
  • To provide updated recommendations for AOM antibiotic therapy.

Main Methods:

  • Literature review of studies on AOM pathogens and antibiotic resistance.
  • Analysis of treatment guidelines and clinical evidence.

Main Results:

  • Amoxicillin remains first-line, with higher dosages (80 mg/kg/day) recommended for resistant Streptococcus pneumoniae.
  • Second-line options include oral cefuroxime, amoxicillin-clavulanate, or intramuscular ceftriaxone.
  • Shorter treatment courses (≤5 days) and less frequent dosing enhance compliance.

Conclusions:

  • Adjusted antibiotic strategies, including higher amoxicillin doses and shorter durations, are crucial for managing resistant AOM.
  • Selective use of tympanocentesis can aid in diagnosis and guide therapy for treatment failures.

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