Otitis Media

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Jessie gives us her pearls regarding otitis media: peds, clinical diagnosis, and antibiotics. 

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Ian L. -

In practice any eardrum bulge will get antibiotics.
The bilateral bulging versus the unilateral is theoretical -few would deny antibiotics if they saw a unilateral bulging drum in a 6-23 month old child with a fever .
The other matter is wax obscuring the drum .
Some gently curette wax if they can if the wax cannot be removed many would treat with antibiotics if the child has been irritable .

Mark B. -

?Duration of 10 days of antibiotics?
I thought we were down to 5-7 days duration???

Jessie W. -

Thanks for your question! The recommendations are varied. It's not such a simple answer. In CorePendium we quote this: "For children >2 years of age with non severe symptoms or those who fail observation period, treat for 5 to 7 days.
For children >2 years of age or any age with severe symptoms, treat for 10 days." But it should also be said that shorter durations work, but with more failures. Longer durations work, but with more side effects.

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