Acute Otitis Media Treatments

Acute Otitis Media Treatments: Newborn-12 Years

ACUTE OTITIS MEDIA TREATMENTS: NEWBORN−12 YEARS
Generic	Brand	Form	Strength	Flavor	Dose
amoxicillin*	Amoxil	drops	50mg/mL	bubble gum	≤12wks: Max 30mg/kg/day in 2 divided doses every 12hrs >12wks (<40kg): 40mg/kg/day in 3 divided doses every 8hrs Or 45mg/kg/day in 2 divided doses every 12hrs ≥40kg: as adult *Note:* The AAP recommends 80−90mg/kg/day in divided doses (this is not an FDA‑approved dose)
		susp	200mg/5mL, 250mg/5mL, 400mg/5mL	bubble gum
		chew tabs	200mg, 400mg	cherry-banana-peppermint
amo xi cillin + clavulanate (clavulanate component in parentheses)	Augmen– tin³	susp	125mg (31.25mg)/ 5mL¹	banana	<12wks: 30mg/kg/day (of amoxicillin) in 2 divided doses every 12hrs (use 125mg/5mL susp) ≥12wks (<40kg): 45mg/kg/day (of amoxicillin) in 2 divided doses every 12hrs (use 200 or 400mg/5mL susp or 200mg or 400mg chew tabs) Or 40mg/kg/day (of amoxicillin) in 3 divided doses every 8hrs (use 125 or 250mg/5mL susp, or 250mg or 500mg chew tabs) ≥40kg: 500mg every 12hrs or 250mg every 8hrs
			250mg (62.5mg)/ 5mL¹	orange
			200mg (28.5mg)/ 5mL², 400mg (57mg)/ 5mL²	orange-raspberry
		chew tabs	125mg (31.25mg)¹, 250mg (62.5mg)¹	lemon-lime
		chew tabs	200mg (28.5mg)², 400mg (57mg)²	cherry- banana
		ES-600 susp	600mg (42.9mg)/ 5mL	strawberry cream	<3mos: Not recommended. ≥3mos (<40kg): 90mg/kg/day in 2 divided doses every 12hrs ≥40kg: use adult formulations
azithromycin	Zithromax	susp	100mg/5mL, 200mg/5mL	cherry-vanilla-banana	<6mos: Not established. ≥6mos: 30mg/kg as a single dose (max 1.5g); or 10mg/kg (max 500mg) once daily for 3 days; or 10mg/kg (max 500mg) once then 5mg/kg (max 250mg) per day for 4 days.
cefaclor	—	susp	125mg/5mL, 187mg/5mL, 250mg/5mL, 375mg/5mL	strawberry	<1mo: Not recommended. ≥1mo: 40mg/kg/day in 2 divided doses every 12hrs, or in 3 divided doses every 8hrs; max 1g/day
cefdinir	—	susp	125mg/5mL, 250mg/5mL	strawberry	<6mos: Not recommended. >6mos: 14mg/kg every 24hrs for 10 days or 7mg/kg every 12hrs for 5−10 days; max 600mg/day
cefixime	Suprax	susp	100mg/5mL, 200mg/5mL	strawberry	<6mos: Not recommended. 6mos−12yrs (<50kg): 8mg/kg once daily or 4mg/kg every 12hrs >12yrs (>50kg): 400mg once daily
cefpodoxime	—	susp	50mg/5mL, 100mg/5mL	lemon-creme	<2mos: Not recommended. ≥2mos: 5mg/kg (max 200mg) every 12hrs for 5 days
cefprozil	—	susp	125mg/5mL, 250mg/5mL	bubble gum	<6mos: Not recommended. >6mos: 30mg/kg/day in 2 divided doses every 12hrs
ceftriaxone	—	inj	500mg/vial, 1g/vial	N/A	50mg/kg IM once; max 1g
cefuroxime	—	tabs	250mg, 500mg	N/A	<13yrs (able to swallow tab whole): 250mg twice daily for 10 days
cephalexin	Keflex	caps	250mg, 500mg, 750mg	N/A	75−100mg/kg/day in equally divided doses
ciprofloxacin	Otiprio⁴	otic susp	6%	N/A	<6mos: Not established. >6mos: one 0.1mL (6mg) single dose into each affected ear, after effusion suctioning
clarithro– mycin	Biaxin	susp	125mg/5mL, 250mg/5mL	fruit-punch	<6mos: Not established. >6mos: 7.5mg/kg every 12hrs for 10 days
sulfameth– oxazole (SMX) + trimethoprim (TMP)	—	susp	200mg (SMX) + 40mg (TMP)/5mL	cherry, grape	<2mos: Not recommended. ≥2mos: 8mg/kg of TMP (40mg/kg of SMX) per day in 2 divided doses every 12hrs for 10 days
trimethoprim	Primsol	soln	50mg/5mL	bubble gum	≥6mos: 10mg/kg daily in 2 divided doses every 12hrs
NOTES
Key: drops = oral drops. susp = oral suspension (as supplied or after reconstitution). ^* Indicates the drug is available under other brand names not shown here. ¹ These formulations are intended to be used in three-times-daily (TID) regimens. Do not substitute plain tabs for chewable tabs. ² These formulations are intended to be used in twice-daily regimens. Do not substitute plain tabs for chewable tabs. ³ These products should be taken with food. ⁴ For intratympanic administration only, in patients with effusion undergoing tympanostomy tube placement. Not an inclusive list of medications, dosing regimens, formulations, and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. Information on prophylaxis of chronic otitis media infections is not included. Under certain clinical conditions (eg, impaired renal or hepatic function), the dose may need to be adjusted. Unless stated otherwise, otitis media is generally treated for 10−14 days. (Rev. 4/2019)

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