Outpatient — Allergy to Penicillins and Cephalosporins
Inpatient
Amoxicillin
★✓✓!
Max daily dosing for amoxicillin (±clavulanate) for otitis media is not consistent in the literature or with actual prescribing practices. Additionally, the literature certainly does not agree with drug labels. Please consider the following options we have found in literature: • Max 1750 mg/day amoxicillin component if q12h (same as adult) • Max 1500 mg/day amoxicillin component if q8h (same as adult) • Max 2,000 mg/day amoxicillin component • Max 3,000 mg/day amoxicillin component • Max 4,000 mg/day amoxicillin component We have provided this max dosing in our calculators.
90 mg/kg/day PO split q8h or q12h10 days if <24 mo or TM perforation; 5–7 days if ≥24 mo
Use the 600 mg/42.9 mg/5 mL (120 mg/mL) [14:1] drug formulation to avoid overdosing on clavulanate
Max daily dosing for amoxicillin (±clavulanate) for otitis media is not consistent in the literature or with actual prescribing practices. Additionally, the literature certainly does not agree with drug labels. Please consider the following options we have found in literature: • Max 1750 mg/day amoxicillin component if q12h (same as adult) • Max 1500 mg/day amoxicillin component if q8h (same as adult) • Max 2,000 mg/day amoxicillin component • Max 3,000 mg/day amoxicillin component • Max 4,000 mg/day amoxicillin component We have provided this max dosing in our calculators.
90 mg/kg/day PO split q8h or q12h10 days if <24 mo or TM perforation; 5–7 days if ≥24 mo
Consult ENT and/or ID before giving; provides coverage for serotype 19A multi-drug resistance Streptococcus pneumoniae which is most common for those that have NOT received PCV
20 mg/kg/day PO/IV split q12h Max dose not clearly defined in this age group Consider discussion with ENT and/or pharmacist about 500 mg/day vs. 750 mg/day
Consult ENT and/or ID before giving; provides coverage for serotype 19A multi-drug resistance Streptococcus pneumoniae which is most common for those that have NOT received PCV
20 mg/kg/day PO/IV split q12h Max dose not clearly defined in this age group Consider discussion with ENT and/or pharmacist about 500 mg/day vs. 750 mg/day
Pneumococcal Vaccination Reduces—but does not eliminate—the risk of pneumococcal infection
Vaccinated — Consider AZITHROMYCIN Good coverage for Haemophilus influenzae and Moraxella catarrhalis Mediocre/low coverage for Streptococcus pneumoniae
UNvaccinated — Consider CLINDAMYCIN Poor coverage for Haemophilus influenzae and Moraxella catarrhalis Good coverage for Streptococcus pneumoniae
Azithromycin5 day treatment
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10 mg/kg PO once on day 1 (max 500 mg) THEN 5 mg/kg PO q24h on days 2-5 (max 250 mg/day)
Consult ENT and/or ID before giving; provides coverage for serotype 19A multi-drug resistance Streptococcus pneumoniae which is most common for those that have NOT received PCV
20 mg/kg/day PO/IV split q12h Max dose not clearly defined in this age group Consider discussion with ENT and/or pharmacist about 500 mg/day vs. 750 mg/day
An infection or inflammation of the middle ear, often following an upper respiratory infection, presenting with ear pain, fever, hearing difficulties, and a bulging, erythematous, or immobile tympanic membrane.