Otitis media and externa: antibiotic therapy recommendations

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Ear

Possible therapeutic alternatives

External otitis (Swimmers ear)

Common pathogens

Cortisporin (Hydrocortisone, polymyxin, neomycin): Instill 4 drops into the affected ear qid or

Ofloxacin (Floxin otic): instill 10 drops into the affected ear bid or

Cipro HC Otic: Instill 3 drops into the affected ear bid for 7 days.

Acute malignant
otitis externa

Common pathogens

Piperacillin 3-4 g IVPB q4-6h + gent/tobra or

Cipro 500-750mg po q12h or Cipro 400mg IVPB q12h or

Ceftazidime 1-2g IVPB q8h or Cefepime 2g IVPB q12h or Imipenem 500mg ivpb q6h

Otitis media:

Common pathogens

Amoxicillin 250-500mg po q8h or

Augmentin 500mg po tid or

Ceclor 250-500mg po q8h or

Cefzil 250-500mg po q12h or

Ceftin 250-500mg po q12h or

Lorabid 400mg po q12h or

Suprax 200-400mg po q12-24h or

Vantin 100-200mg po q12h or

Cedex 400mg po qd

Alternatives (Penicillin allergic): Bactrim or Clarithromycin or Zithromax.

Pain relief (Acute otitis media)

Auralgan � Otic Solution: Instill Auralgan permitting the solution to run along the wall of the canal until it is filled. Avoid touching the ear with dropper. Then moisten a cotton pledget with Auralgan and insert into meatus. Repeat every one to two hours until pain and congestion are relieved.

Otitis externa

Antimicrobial Series
References

American Hospital Formulary Service. Drug Information. Bethesda, MD: ASHP, 1997.

Baden LR, Eisenstein BI.Impact of Antibiotic Resistance on the Treatment of Gram-negative Sepsis.
Curr Infect Dis Rep. 2000 Oct;2(5):409-416.

Bartlett JG et al. Community-acquired pneumonia in adults: guidelines for management. Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 1998;26:811-38.

Bartlett JG: Empirical therapy of community-acquired pneumonia: macrolides are not ideal choices. Semin Respir Infect 1997 Dec; 12(4): 329-33

Bartlett JG.1998 Pocket Book of Infectious Disease Therapy., Ninth Edition. Baltimore,MD: Williams&Wikins,1998.

Bernstein JM: Treatment of community-acquired pneumonia--IDSA guidelines. Infectious Diseases Society of America. Chest 1999 Mar; 115(3 Suppl): 9S-13S

Drug Information Handbook, 5th Ed. 1997, Lexi-Comp inc.

Ewig S et al. Pneumonia acquired in the community through drug-resistant Streptococcus pneumoniae. Am J Respir Crit Care Med. 1999;159:1835-42.

File TM Jr. Community-acquired pneumonia: recent guidelines for therapy. J Respir Dis. 1999;20:534-41.

Gilbert DN, Moellering RC, Sande MA. The Sanford Guide to Antimicrobial Therapy 2000. 30th ed. Hyde Park,VT: Antimicrobial Therapy, Inc.; 2000.

Gold HS, Moellering RC. Antimicrobial-drug resistance. N Engl J Med. 1996;335:1445-1453.

Gonzales R, Sande M: What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 1995 Mar 18; 345(8951): 665-6

Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am 1997;11:551-581.

Lipsky BA, Berendt AR.Principles and practice of antibiotic therapy of diabetic foot infections.
Diabetes Metab Res Rev. 2000 Sep-Oct;16 Suppl 1:S42-6.

Mufson MA.Pneumococcal Pneumonia.
Curr Infect Dis Rep. 1999 Apr;1(1):57-64.

Reese RE, Betts RF: A Practical Approach to Infectious Diseases. 4th ed. Boston: Little, Brown, and Company; 1996: 251

Stefani SD, Cadore LP, Villaroel RU, Azevedo S, Machado AL. Antibiotic Selection in the Treatment of Febrile Neutropenia: Current Approach and New Directions.
Braz J Infect Dis. 1998 Jun;2(3):109-117.

Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med 1993;329:1328-1334.