ANTIBIOTIC PRESCRIBING
An antibiotic regimen plus symptom management is the first-line approach in adults with acute otitis media. A "wait and see" approach that delays the use of antibiotics to see if spontaneous resolution occurs has not been evaluated in adults. Antibiotic options include amoxicillin/clavulanate (Augmentin) 1 g every 12 hours. Alternatives for patients with penicillin allergy include
- Cefdinir 300 mg every 12 hours or 600 mg every 24 hours
- Cefuroxime 250 mg every 12 hours
- Cefpodoxime 200 mg every 12 hours
- Azithromycin 500 mg as single dose on day 1, then 250 mg once daily on days 2-5
- Clarithromycin 500 mg every 12 hours
- Cefprozil 250 mg every 12 hours, or 500 mg every 12 hours for more severe infections
REFERENCES
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Szmuilowicz, J., & Young, R. (2019). Infections of the Ear. Emergency Medicine Clinics of North America, 37(1), 1–9. Available at: https://doi.org/10.1016/j.emc.2018.09.001
NICE Clinical Knowledge Summary, Otitis media – acute. Available at: https://cks.nice.org.uk/otitis-media-acute