Common causes? (3)
strep pneumonia
H. influenza
RSV
Presentation?
follow URTI, earache, fever, deafness (often precedes pain), irritability, lethargy.
Inflamed tympanic membrane, loss of light reflex, bulging drum.
When should Abx be prescribed immediately?
⎫ Symptoms lasting > 4 days or not improving
⎫ Systemically unwell but not requiring admission
⎫ Immunocompromised or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease
⎫ < 2 years of age with bilateral otitis media
⎫ Otitis media with perforation and/or discharge in the canal
Which first line Abx?
Amoxicillin