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What are the top 3 organisms that cause AOM?
Strep pneumo, H. Influenzae, M. Catarrahalis
What is the tx of choice? 2nd line?
- 1st: amoxicillin 40mg/kg/d, 80 if resistance suspected.
- 2nd line: 3rd gen cephalosporin (ceftriaxone or cefdinir)
What's the safety net to antbx approach to prescriptions (SNAP approach) to AOM?
Give rx but tell parents not to fill unless kid not responding to analgesics after 2 days.
When does the SNAP approach not apply?
Temp> 101.5, sx > 2 days, AOM in last 3 months, toxic appearing, damaged TM, impaired immunity, caregivers don't understand or unlikely to seek tx if worsening
What are the 4 modifiable risk factors for AOM?
Bottle or pacifier use, daycare attendance, exposed to 2nd hand smoke
What are the 2 non-modifiable risk factors for AOM?
Atopic states and craniofacial abnormalities (cleft palate, Down syndrome)
What's the 2 major Ddx of AOM?
Otitis media w/ effusion and viral myringitis
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