Acute Otitis Media Treatments

Acute Otitis Media Treatments: Newborn-12 Years

ACUTE OTITIS MEDIA TREATMENTS: NEWBORN−12 YEARS
Generic	Brand	Strength	Form	Flavor	Dose
amoxicillin	—	125mg/5mL, 200mg/5mL, 250mg/5mL, 400mg/5mL	susp	raspberry-strawberry	≤3mos: Max 30mg/kg/day in 2 divided doses every 12hrs. >3mos (<40kg): 20mg/kg/day in 3 divided doses every 8hrs. Severe: 40mg/kg/day in 3 divided doses every 8hrs. ≥40kg: 250mg every 8hrs. Severe: 500mg every 8hrs Note: The AAP recommends 80–90mg/kg/day in divided doses (this is not an FDA-approved dose)
amoxicillin + clavulanate	—	200mg/28.5mg, 400mg/57mg	chew tabs	cherry-banana	Base dose on amoxicillin component. <12wks: 30mg/kg/day in 2 divided doses every 12hrs (use 125mg/5mL). ≥12wks (<40kg): Twice-daily regimen: use 200mg or 400mg. Three times daily regimen: use 125mg or 250mg. 45mg/kg/day in 2 divided doses every 12hrs or 40mg/kg/day in 3 divided doses every 8hrs. ≥40kg: 500mg every 12hrs or 250mg every 8hrs
	Augmen– tin¹	125mg/31.25mg per 5mL	susp	banana
		250mg/62.5mg per 5mL	susp	orange
		600mg/42.9mg per 5mL	ES-600 susp	strawberry cream	<3mos: Not recommended. ≥3mos (<40kg): 90mg/kg/day in 2 divided doses every 12hrs ≥40kg: Not recommended (use adult forms)
azithromycin	Zithromax	100mg/5mL, 200mg/5mL	susp	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	—	125mg/5mL, 250mg/5mL, 375mg/5mL	susp	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	—	125mg/5mL, 250mg/5mL	susp	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	100mg/5mL, 200mg/5mL	susp	strawberry	<6mos: Not established. 6mos−12yrs (<50kg): 8mg/kg once daily or 4mg/kg every 12hrs >12yrs or >50kg: 400mg once daily or 200mg every 12hrs
cefpodoxime	—	50mg/5mL, 100mg/5mL	susp	lemon-creme	<2mos: Not recommended. ≥2mos: 5mg/kg (max 200mg) every 12hrs for 5 days
cefprozil	—	125mg/5mL, 250mg/5mL	susp	bubble gum	<6mos: Not recommended. >6mos: 30mg/kg/day in 2 divided doses every 12hrs
ceftriaxone	—	500mg/vial, 1g/vial	inj	—	50mg/kg IM once; max 1g
cefuroxime	—	250mg, 500mg	tabs	—	<13yrs (able to swallow tab whole): 250mg twice daily for 10 days
cephalexin	Keflex	250mg, 500mg, 750mg	caps	—	75−100mg/kg/day in equally divided doses
ciprofloxacin	Otiprio²	6%	otic susp	—	<6mos: Not established. >6mos: one 0.1mL (6mg) single dose into each affected ear, after effusion suctioning
clarithro– mycin	—	125mg/5mL, 250mg/5mL	susp	fruit-punch	<6mos: Not established. >6mos: 7.5mg/kg every 12hrs for 10 days
sulfameth– oxazole/ trimethoprim	—	200mg/40mg per 5mL	susp	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
NOTES
Key: drops = oral drops; SMX = sulfamethoxazole; susp = oral suspension (as supplied or after reconstitution); TMP = trimethoprim ¹ These products should be taken with food. ² 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. 5/2021) Related Content

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Acute Otitis Media Treatments

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