4.1.2.2
Acute Otitis Media
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 4, Ear, Nose and Throat Conditions.
Clinical Description
This is an infection of the middle ear, which communicates with the throat. It is important in a febrile child to look for it and treat it. If persists for more than 72 hours, then start antibiotics. If it does not resolve for a further 72 hours, then, refer. Tropical medicine treatment is ineffective and should beavoided.
Acute otitis media is often viral in origin and needs only a simple analgesic for pain
Signs and Symptoms
- Fever in about 50% of patients, sudden persistent ear pain or pus discharge for < 2 weeks
- Red eardrum
- Occasionally inflamed throat
- Perforated eardrum
Investigations
- FBC
- Ear swab for culture and sensitivity
Pharmacological
- Give Amoxicillin 15 mg/kg every 8 hourly for 5 days
Alternatively:
- Give Erythromycin 6.25 mg/kg every 8 hourly or Azithromycin 10mg/kg stat then 5mg/kg q24h for total maximum 5 days for patients with penicillin allergy
- Give Analgesia as required
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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