A 1-month-old boy has a fever to 102.7°F (39.3°C), is irritable, has diarrhea, and has not been eating well. On examination he has an immobile red TM that has pus behind it. Which of the following is the most appropriate course of action? A. Admission to the hospital with complete evaluation. B. Intramuscular ceftriaxone and close outpatient follow-upC. Oral amoxicillin-clavulanate. D. Oral cefuroximeE. High-dose oral amoxicillin

Question

Braden

Biology

18 November, 02:53

A 1-month-old boy has a fever to 102.7°F (39.3°C), is irritable, has diarrhea, and has not been eating well. On examination he has an immobile red TM that has pus behind it. Which of the following is the most appropriate course of action? A. Admission to the hospital with complete evaluation. B. Intramuscular ceftriaxone and close outpatient follow-upC. Oral amoxicillin-clavulanate. D. Oral cefuroximeE. High-dose oral amoxicillin

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Answers (1)

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Alex Haas · Answer 1

Answer: E. High-dose oral amoxicillin is the appropriate therapy.

Explanation:

The pathology described is a case of Acute Otitis Media (AOM).

AOM is a common childhood disorder caused mainly by bacterial organisms.

The treatment of AOM is as follows:

1. "Watchful waiting" period of a few days may be indicated since many AOM cases self-resolve.

2. Should antibiotics be deemed necessary and depending on a community's bacterial resistance patterns, amoxicillin at doses up to 80 to 90 mg/kg/d for 7 to 10 days is often the initial treatment. If clinical failure is noted after 3 treatment days, a change to amoxicillin-clavulanate, cefuroxime axetil, azithromycin, cefixime, ceftriaxone, or tympanocentesis is considered.