1. acute otitis media
    rapid onset of signs and sx of inf of middle ear
  2. effusion
    accumulation of fluid in middle ear
  3. otorrhea
    discharge from ear
  4. high prevalence of AOM
    first 2 yrs
  5. AOM more common in which season?
  6. envir factors of AOM
    • daycare attendance
    • parental smoking
    • breastfeeding-protective
  7. race at risk for AOM
    • native amer
    • whites
  8. organisms involved in AOM
    • Strep pneu
    • Hae inf(non-typeable)
    • Moraxella catarrhalis
    • various others: S aur, E coli, Pseu aeruginosa
  9. clinical presentation of AOM
    • otalgia
    • hearing loss
    • fever
    • -also can be irritable, lethargic, no appetite, paci
  10. signs of inflammation
    • redness or opacity of typ mem
    • absense of light reflection
    • bulging tympanic membrane
    • immobility of tymp mem
    • otorrhea
  11. symptomatic tx of AOM
    • APAP-10-15mg/kg/dose q 4-6 h
    • Ibu 5-10 mg/kg/dose q 6-8 h
    • topical:
    • Aralgan-antipyrine/benzocaine solution, fill and mr 1-2 hrs prf p CONTRA in perforated tymp
    • or neomycin/polymyxin B/HC otic susp3 gtts 3-4x/d
  12. abx appropriate under six mo?
    • questionable diag: yes
    • def diag: yes
  13. abx app 6 mo-2 yrs
    • questionable: if sign ear pain and fever eq or greater than 39C
    • def: yes
  14. abx app >2 yrs
    • questionable: consider observation
    • def: if sign ear pan and fever equal or great to 39, or 102
  15. complications of AOM
    • hearing loss (assoc w scarring)
    • mastoiditis
    • meningitis
  16. when are ABx recommended if appropriate
    after being tx w abx initially or have failed 48-72 hrs of observation or initial management w anbicaterial agenets
  17. dose of amox
  18. dose of augmentin
    90mg/kg per day amox and 6.4 mg/kg/d clav
  19. if failed trial w initial abx
    aug or ceftriaxone 3 days
  20. fever and/or severe olagia
    aug, if allergy-ceftriaxone
  21. no fever and/or severe otalgia
    amox or allergy, non-type:ceftriaxone, cefpodoxime, type 1: azith or clarith
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