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Otitis media


It is an inflammation of the middle ear cavity. It is considered acute when the inflammation is of less than 2 weeks duration, and chronic when the inflammation is of more than 2 weeks duration with tympanic membrane perforation. 

Diagnostic Criteria

  • Examine the pinna; 

  • Using an otoscope carefully examine the external auditory canal and the tympanic membrane

Acute Otitis Media

Diagnostic Criteria

  • Previous upper respiratory tract infection 

  • Painful ear

  • Restlessness

  • Fever 

  • Hearing often reduced

  • Inflamed, bulged tympanic membrane

Non-Pharmacological Treatment:


Acute otitis media should be treated with analgesics, antibiotics and/or paracentesis (to reduce pain and to obtain pus for culture and sensitivity) 

Pharmacological treatment:

  • Phenoxymethylpenicillin (PO). Adults: 500mg 6 hourly for 10days; Children up to 5 years: 6 mg/kg 6 hourly for 10 days    


  • Amoxicillin+Clavulanic acid 375–625mg 12 hourly for 10 days    


(for patients who are allergic to penicillin) 

  • Azithromycin (PO). Adults: 500mg once daily for 5 days and Children 10mg/kg   once daily for 5 days 


  • Paracetamol (PO). Adults: 1g 6 hourly for 3 days and Children: 10 mg/kg 6 hourly for 3 days  


Note: Treatment periods shorter than 10 days increase the risk of treatment failure  



Referee this case to higher centre for further management by ENT specialist when;

  • Children with high fever, severe ear pain, headache, altered state of consciousness

  • A chronically discharging ear that persists in spite of proper treatment.

  • Foul smelling ear discharge 

  • Mastoiditis 

Otitis in the normal (or better hearing) ear combined with permanent hearing loss in the other ear

Updated on, 30.10.2020


1. STG 

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