Diagnosis and management of acute otitis media in the urgent care setting

Annals of Emergency Medicine
George H McCracken

Abstract

The prevalence of otitis media is increasing, which affects health care resource utilization across all segments, including the urgent care setting. One of the greatest challenges in the management of acute otitis media (AOM) is the effective treatment of cases caused by pathogens that are resistant to commonly used antibiotics. Whereas the production of beta-lactamases among strains of Haemophilus influenzae and Moraxella catarrhalis is an important consideration for antimicrobial therapy, the high prevalence of resistance to penicillin and other classes of antibiotics among strains of Streptococcus pneumoniae represents a greater clinical concern. The Centers for Disease Control and Prevention (CDC) recently convened the Drug Resistant S. pneumoniae Therapeutic Working Group to develop evidence-based recommendations for the treatment of AOM in an era of prevalent resistance. The recommendations from this group included amoxicillin as the preferred first-line drug because of the demonstrated activity against penicillin-intermediate and -resistant strains of S. pneumoniae, using higher dosages of up to 90 mg/kg per day in certain settings. For patients in whom initial treatment is unsuccessful after 3 days, the recommended agen...Continue Reading

Citations

Jan 12, 2005·Pediatric Emergency Care·Jonathan SingerJonathan Taylor
Mar 20, 2014·The Annals of Otology, Rhinology, and Laryngology·Leman BirdaneArmagan Incesulu
Jun 1, 2009·Probiotics and Antimicrobial Proteins·L M T DicksC A van Reenen
Feb 11, 2004·The Pediatric Infectious Disease Journal·Antonio Arrieta, Jasjit Singh

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