otitis media is difficult to investigate because of wide variations in diagnostic
criteria and measurements of outcome. However, the authors chose to
simulate an outpatient practice with clinical criteria of fever, otalgia,
and irritability combined w/ otoscopic findings--discoloration, bulging.
studies have documented the effectiveness of one IM dose of Ceftriaxone (50mg/kg)
for the initial treatment of AOM.
ear fluid penetrance characteristics and its long half-life are favorable
for time-dependent killing by Ceftriaxone.
the most common causative bacteria in AOM are also isolated in nasopharyngeal
culture, the positive predictive value is poor for bacteriologic diagnosis
of AOM. However, use of nasopharyngeal culture has been demonstrated
as useful in monitoring changes in resistance of "potential" otic pathogens.
Ceftriaxone is not "first line" therapy for AOM, consideration for its usefulness
in geographic areas of high penicillin resistance/individual w/ persistent
infection presumed to be secondary to resistant organisms, can be given.
events include rash and less often GI complaints.
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