Hunter Hoover, MD
- Approach to diagnosing AOM:
- Step 1: Is there fluid or not? No --> not AOM
- Step 2: If yes, reposition the otoscope to see if is the TM bulging by visualizing the handle and the short process. This is the best predictor for bacterial infection with 90% sensitivity.
- High dose amoxicillin first first line (80-90 mg/kg)
- Augmentin can be first line for severe symptoms
- Treatment in penicillin allergy:
- Third gen cephalosporin has <1% true cross reactivity and generally safe
- I.e. three shots of rocephin
- If allergic to pen and ceph, then will have to use clindamycin and septra together.
- Duration of treatment:
- Studies were done for 3-5 days of treatment