AOM - recurrent
- ≥ 3 episodes in 6 months
or
- ≥ 4 episodes in 12 months with at least 1 episode in past 6 months
- Observation over time is reasonable because of a decreasing incidence of AOM with advancing age.
- Antibiotic prophylaxis is NO longer recommended.
- Consider ENT referral if:
- OME for ≥ 3 months with hearing loss ≥ 40 dB
- ≥ 3 episodes in 6 months
- ≥ 4 episodes in 12 months with at least 1 episode in past 6 months
- retracted tympanic membrane
- cleft palate or craniofacial malformations.
S. pneumoniae
Moraxella catarrhalis
H. influenzae
Occasionally:
Group A Streptococci
S. aureus
> 6 weeks from last episode
| Empiric Therapy | Dose | Duration |
|---|---|---|
|
Use high dose amoxicillin See AOM - healthy child |
10 days |
< 6 weeks from last episode
See AOM - failure of first line agents