Explanation . . The child now has developed acute otitis m | 👼Pediatrics. Books,Videos, MCQs...

Explanation

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The child now has developed acute otitis media with effusion. Viral upper respiratory infections are the most frequent antecedent of otitis media in young children. They result in eustachian tube dysfunction that predisposes to middle ear bacterial superinfection, most commonly by S pneumoniae, nontypeable Haemophilus influenzae, or Moraxella catarrhalis. Amoxicillin is considered by many authorities to be first-line therapy for otitis media. Because of increasing pneumococcal penicillin resistance rates, high doses (ie, 80–90 mg/kg/day) are appropriate. This is especially true in the context of day care attendance because of the increased risk for resistant pneumococci among children in this setting. Ceftriaxone has been demonstrated to be effective in the management of otitis media, but should generally be
reserved for cases not responsive to initial antibiotic management. Erythromycin is not appropriate in the treatment of this infection because many of the offending organisms are resistant. An otorhinolaryngology consult is not routinely necessary in the management of acute otorrhea. (Rudolph CD,1249–1255)