smalley
Forum Elite
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a previously healthy 3 month old baby is brought to the hospital.he continues to have fever and ear pain despite treatment with amoxicillin for 72 hrs.examination shows immobile red and opaque tympanic memb.which is the most likely pathogen
a)chlamydia
b)group A strep
c)hemophilus influenza
d)mycoplasma pneumonie
e)staph aureus
pls exp
thanks
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| liliaeliz
Forum Elite
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Posts: 237
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AOM ..STREPTO, HI, MORAXELLA ANSWER C
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| lq2006
Forum Elite
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c)hemophilus influenza
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| WaqasQureshi
Forum Newbie
Topics: 2
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it is C.
The most common organisms are step A then hemophilus non typeable is a close second and then morexalla.
the incidence of resistance ot AMoxicillin in H. influenzae is higher because of the beta lactamase production so it is likely hemophilus.
the other options can be ruled out as:
chlamydia: usually doesnt present as OM unless there is incidence just after birth with purulent conjunctival discharge and perforated TM. presents subacutely. Very rare cause
mycoplasma is also a very rare cause of OM and is usually associated with bullous myringitis. Presents subacutely
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| WaqasQureshi
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algorithm for AOM:
treat with amoxicillin in case of history and physical consistant with AOM:
check response for 48-72 hours
if no change in condition:
consider changing it to amoxicillin + clavulanate
other indications for Augmentin are:
- previous h/o infection with same organisms within last month
- pevious h/o treatment with amoxicillin within last month
- documentation of resistant organisms
- 48-72 hours failure of trial of emperical therapy of amoxicillin
Treatment duration is:
10 days:
- age less than 5 years
- resistant organism
7 days:
Other drugs for resistant organisms:
- cefidinir, cefuroxime axetil,
- if emergent: use IM ceftriaxone
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