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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
