From the FDA Drug Label
2.2 Dosage for Adults and Pediatric Patients Aged 3 Months (12 weeks) and Older ... Ear/Nose/Throat Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours
For a 20-year-old patient with Acute Otitis Media (AOM), the recommended dosing and frequency of amoxicillin is:
- Severe: 875 mg every 12 hours
- Mild/Moderate: 500 mg every 12 hours or 250 mg every 8 hours 1
From the Research
For acute otitis media (AOM) in a 20-year-old, the recommended dosage of amoxicillin is 875 mg taken twice daily (every 12 hours) for 5-7 days. This high-dose regimen is effective against most common bacterial pathogens causing AOM, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 2. The patient should complete the full course of antibiotics even if symptoms improve before completion to ensure complete eradication of the infection and prevent recurrence.
Key Considerations
- The medication should be taken with food to minimize gastrointestinal side effects such as nausea or diarrhea.
- If symptoms worsen or do not improve within 48-72 hours, the patient should follow up with their healthcare provider as this may indicate antibiotic resistance requiring a change in therapy.
- Common side effects include diarrhea, stomach upset, and vaginal yeast infections.
- Patients with penicillin allergy should not take amoxicillin and should inform their healthcare provider immediately if they develop a rash, itching, or difficulty breathing after taking the medication.
Evidence-Based Decision
The most recent and highest quality study 2 supports the use of amoxicillin for AOM, although it notes that antibiotics have a limited effect on pain and other outcomes compared to placebo. However, in the context of real-life clinical medicine, the potential benefits of antibiotic treatment in reducing the risk of complications and promoting recovery outweigh the risks, particularly in patients with severe symptoms or those at high risk of complications.
Additional Factors
- The choice of antibiotic and duration of treatment should be guided by local resistance patterns and clinical guidelines.
- Patients should be educated on the importance of completing the full course of antibiotics and the potential risks and benefits of treatment.