3-year-old girl brought by her parents for the following:
- Ear ache right side x 24 hours
- Eating less but drinking well
- Coughing and runny nose +++
- Did not sleep the last night
Parents are tired. They want relief.
- Hugging her mother
- Irritable but calm when not approached
- Tympanic temperature = 38.4
- Erythematous tympanic membrane; not bulging
- Obvious nasal discharge
- No lymphadenopathy
- Normal oropharynx normal
- Respiratory exam normal
What should you do?
a) Oral amoxicillin now.
b) Viral prescription.
c) Delayed amoxicillin prescription.
Uncomplicated Otitis Media:
You should consider antibiotics in vaccinated children > 6 months and adults ONLY in the following circumstances:
- The tympanic membrane is suspected to be perforated and there is a purulent discharge.
- The tympanic membrane is red and bulging WITH one of the three following criteria;
- A fever is present (≥ 39ºC) OR,
- The patient is moderately or severely ill OR,
- Symptoms lasting > 48 hours.