عفونت گوش میانی ،ویرایش نشده

Acute otitis media ( AOM ):    ( OPD )عفونت گوش میانی 

1. Antibiotics:

-Amoxicillin ( low dose ) : ( SYR 125mg/5 ml ,250mg/5ml & Cap 250,500): 15mg/kg/dose TDS  10days

-Amoxicillin ( high dose ): 30 mg/kg/dose TDS

[ in: (1) antibiotics use in preceding 1-3 months; (2) age 2 years : (3) daycare

Attendance ;(4) failure to respond to initial Amoxicillin within 72 h)

Or Amoxicillin 13 mg/kg/dose TDS+ Coamoxiclav ( SYR 156/5 contains 125 mg

Amoxicillin , 312/5 contains 125mg amoxicillin & Tab 375 contains 250 mg

Amoxicillin , 625 contains 500 mg amoxicillin ): 13mg/kg/dose TDS

20mg/kg/dose amoxicillin +20mg/kg/dose coamoxiclav BID

-or Farmentin =Clavicillin (= coamoxiclav BD )  ( 228/5 contains 200 mg amoxicillin & 457/5 contains 400mg amoxicillin ) : 40mg /kg/dose BID

-(If severe or resistant to oral regimen ): ceftriaxone (Amp 500mg&1g ): 50-75 mg/kg IV , IM  1-3 days

-(IF allergy to penicillin) : Azithromycin ( SYR 100/5 , 200/5 & cap 250 & 500 ) 10mg / kg / QD on day 1; then 5 mg / kg / d  4 days

Or : clarithromycin : ( SYR 125/5 & 250/5 & Tab 250 & 500) : 7.5 mg / kg / dose BID

2. Acetominophen  15 mg / kg / dose q 4-6 h ; or ibuprofen ( Brufen ) : 5-10 mg / kg / dose QID or Naproxen : 5-7 mg / kg / dose TDS-QID

3.If nasal discharge : nasal drop Nacl 1-2 drop q 4-6 h