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Acute Otitis Media

Stuart Swadron MD, Solomon Behar, MD, and Mizuho Morrison, DO
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32:43
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Sol and Stuart discuss AAP guidelines on management of AOM to keep you fresh on your clinical management based on age, length of symptoms, who and when to treat and with what antibiotic selections to make.

 

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Michael C. -

Hi Sol,
This was useful.
I was wondering about what you do for dosing situation as kids get bigger. Where do you max out, do you ever go for TID dosing, do you use adult dosing in big kids or go beyond to hit that 90/kg.

Rhone D. -

My understanding was that Auralgan has been pulled by the FDA. We were told to stop writing for it in July.

https://www.federalregister.gov/articles/2015/07/02/2015-16360/unapproved-and-misbranded-otic-prescription-drug-products-enforcement-action-dates

Solomon B., MD -

Rhone- thanks for that comment. From what I understand, after reading your link, the brand name Auralgan was pulled after the manufacturers changed an ingredient (glycerine) to another beeswax derived ingredient. I know we have on our formulary a generic version of benzocaine/antipyrine available. Either way, the pain relief is brief!

Solomon B., MD -

MIchael- If the 90 mg/kg dosing goes above adult dosing (some resources say max is up to 4g/day), then I do not exceed that. My usual practice is to do a max of 1g PO TID. If you are concerned about compliance, dividing the total dose BID (instead of TID) is reasonable.

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UTI and SBI, FYI. Full episode audio for MD edition 193:44 min - 91 MB - M4AHippo Peds RAP November 2015 Summary 644 KB - PDF