Page 142 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 142

Suggested Treatment
                      Infection/ Condition                                                                                             Comments
                                                               Preferred                             Alternative

                 Acute diffuse otitis externa    Ofloxacin 0.3% otic solution          Amoxicillin/clavulanate 625mg PO q8h if   Aural toileting required in
                                                 Instil 10 drops  into affected ear(s) once   not responding                   discharging ears
                                                 daily  for 7 days


                 Chronic Suppurative Otitis      Ofloxacin 0.3% otic solution          Amoxicillin/clavulanate 625mg PO q8h if   Aural toileting required in
                 Media                           instil 10 drops  into affected ear(s) twice   not responding                  discharging ears
                                                 daily for 10-14 days


                 Otomycosis                      Clotrimazole 1% ear solution, applied                                         Aural toileting required.
                                                 twice daily for 10 to 14 days


                 Perichondritis                  Ciprofloxacin 750mg PO q12h                                                   Targeted therapy is
                                                                                                                               recommended once culture is
                                                 PLUS/MINUS                                                                    available.
                                                 Clindamycin 600mg QID
                                                 For 7 days


                 Acute Mastoiditis               Amoxicillin/clavulanate 1.2gm IV q8h    Ceftriaxone 2gm IV q12-24h

                                                 OR
                                                 Ampicillin/sulbactam 3g q8h



                        References:
                    1.  Thanaviratananich S, Laopaiboon M, Vatanasapt P. Once or twice daily versus three times daily amoxicillin with or without clavulanate for the treatment
                        of acute otitis media. Cochrane Database Syst Rev 2013; 12:CD004975.
                    2.  Wessels MR. Clinical practice. Streptococcal pharyngitis. N Engl J Med 2011; 364:648.
                    3.  Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics 2013; 131:e964.
                    4.  Kaplan EL, Gooch III WM, Notario GF, Craft JC. Macrolide therapy of group A streptococcal pharyngitis: 10 days of macrolide therapy (clarithromycin)
                        is more effective in streptococcal eradication than 5 days (azithromycin). Clin Infect Dis 2001; 32:1798.



               HPP AMG                                                  Otorhinolaryngology Infections                                                   66
   137   138   139   140   141   142   143   144   145   146   147