Term
| Should analgesics be used for AOM in children? Which analgesics ? |
|
Definition
| Yes, APAP or Ibuprofen dosed by weight. Can use codeine in severe pain |
|
|
Term
| When should the patient be referred? |
|
Definition
| Temperature over 39, bacterial infection, toxic, treatment failures or unresponsive to therapy, refer to ENT. |
|
|
Term
|
Definition
| A red, bulging opaque tympanic membrane |
|
|
Term
|
Definition
| Abx use, daycare attendance, recent AOM |
|
|
Term
| 6 week to 6 month old treatment algorithm |
|
Definition
| watch & wait not recommended treat with high dose Amoxicillin for 10 days |
|
|
Term
| If child has risk factors, what medication should be used? |
|
Definition
| Analgesics with high dose Amoxicillin for 5-10 days (younger the longer treatment) |
|
|
Term
| If child dose not have risk factors what should be done? For how long |
|
Definition
| Watch and wait for 2-3 days, but give analgesics for pain |
|
|
Term
| Bacterial pathogens in AOM |
|
Definition
| Strep Pneumo, H. Influenze, Moraxella catarrhalis |
|
|
Term
| In resistant S.Pneumoniae what should be done? |
|
Definition
| Double dose of Amoxicillin |
|
|
Term
| In resistant H. influenzae & M. catarrhalis ? |
|
Definition
|
|
Term
| What can be used in case of non type 1 hypersensivity to penicillin allergies? |
|
Definition
| Cephalosporins - cefuroxime and cefprozil |
|
|
Term
| Which cephalosporins should be used in case of non-type 1 hypersensitivity penicillin allergies vs. H. influenzae or M. Catarrhalis ? How are cephalosporins vs. amoxicillin against penicillin resistant S. Pneumoniae? |
|
Definition
| Cefuroxime or cefprozil (both 2nd generation) Cephalosporins are not as effective as amoxicillin vs. penicillin resistant strains so should be used 2nd line. |
|
|
Term
Which Abx's should be used in type 1 hypersensitivity to beta lactam antibiotics ?
Which of these dose not cover H.influenzae or M. Catarrhalis? |
|
Definition
Azithromycin, clarithromycin, and clindamycin
H.influenzae or M. Catarrhalis not covered by clindamycin |
|
|
Term
| Should amoxicillin be refrigerated? |
|
Definition
| YES to preserve for 14 days. If not only lasts 7 days. |
|
|
Term
How long is amoxicillin suspension good for ?
room temp & fridge |
|
Definition
amoxicillin suspension:
7 days at room temp
14 days in the fridge |
|
|
Term
| Should azithromycin be refrigerated? |
|
Definition
|
|
Term
| Should cephalosporins be taken with food? What is the exception? |
|
Definition
| Cephalosporins should be taken with or without food, the exception is cefuroxime - take with food. |
|
|
Term
| Important note about Amox/clav capsules vs. tablets |
|
Definition
| Amox/clav capsules and tablets do NOT contain the same amount of clavulanate, do not substitute. |
|
|
Term
| Is there a cross allergy between cephalosporins and penicillins? |
|
Definition
| YES ~10%. Only substitute cephalosporins for penicillins in non-type 1 allergy. |
|
|
Term
| When should azithrymycin or clarithromycin be used in AOM? |
|
Definition
| Use in type 1 sensitivity to penicillins |
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