Page 249 - HPP ANTIMICROBIAL GUIDELINE 2018

Infection/Condition Suggested Treatment Comments
Preferred Alternative

Acute Otitis Media If no antibiotic in prior month: Received antibiotics prior month:
Streptococcus pneumonia Amoxicillin 90mg/kg/day in 2-3 divided doses Amoxicillin/clavulanate 90mg/kg/day PO in
Haemophilus influenza 2 divided doses
Moraxella catarrhalis Duration:
<2 yrs old: 10days OR
≥2 yrs old: 5-7 days Cefuroxime 15 mg/kg PO q12h

Penicillin Allergy:
Clarithromycin 7.5mg /kg PO q12h

OR
Azithromycin 10mg/kg PO on day 1,
followed by 5mg/kg PO q24h on day 2 to
day 5

Acute Diffuse Otitis Ofloxacin 0.3% otic solution Aural toileting required in
Externa instil 5 drops into affected ear(s) once daily discharging ears
P. aeruginosa and for 7 days 1-12 years
Staph. aureus > 12 years refer to adult dose

References:

1. Wald ER, Applegate KE, Bordley C, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to
18 years. Pediatrics 2013; 132:e262.
2. Chow AW, Benninger MS, Brook I, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012;
54:e72.
3. Bradley JS, Jackson MA, Committee on Infectious Diseases, American Academy of Pediatrics. The use of systemic and topical fluoroquinolones.
Pediatrics 2011; 128:e1034.
4. Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics 2013; 131:e964.
5. Altamimi S, Khalil A, Khalaiwi KA, et al. Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children.
Cochrane Database Syst Rev 2012; 8:CD004872.
6. Wroe PC, Lee GM, Finkelstein JA, et al. Pneumococcal carriage and antibiotic resistance in young children before 13-valent conjugate vaccine. Pediatr
Infect Dis J 2012; 31:249.

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