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Basic Otitis Media
| Question | Answer |
|---|---|
| causes of AOM | strep. pneumonia, H-flu, Moraxella catarrhalis |
| Viral causes of AOM | RSV, adenovirus, influenza A and B |
| percent of AOM that resolve on their own | 80% |
| First line therapy | Amoxicillin; if treatment fails then Augmentin |
| Criteria for 10 days of antibiotics | less then 2 years old, immunosupressed, cranial-facial abnormalities |
| when antibiotics would be indicated for OME | persists for more then 3 months |
| criteria for "watch and wait" | ready means of communication, system to re-evaluate in 48-72 hours, ability to obtain medication in a timely matter if treatment failure occurs |
| Amoxicillin and clavulanate | augmentin |
| If PCN allergy | cephalosporin, macrolide |
| persistent OM | AOM that persists past 6 days of antimicrobial therapy or that recurs within a few days after treatment is discontinued |
| recurrent OM | 3 episodes within 6 months or 4 episodes within 12 months |
| safety net antibiotic prescription | amox. script to be filled if symptoms do not improve in 48-72 hours, should have experation date of 5 days |