From the Guidelines
Your child has been diagnosed with a left middle ear infection (otitis media) and prescribed amoxicillin, which should be given exactly as prescribed, typically twice daily for 10 days, even if symptoms improve before finishing the course. The dosage of amoxicillin should be 80 to 90 mg per kg per day, as recommended by the American Academy of Pediatrics and the American Academy of Family Physicians 1. It is essential to manage pain with acetaminophen or ibuprofen according to weight-based dosing on the package.
To prevent further complications, keep the ear dry during bathing by avoiding submerging the head underwater. Monitor your child's condition closely and watch for fever above 102°F that persists despite medication, increased ear pain, swelling behind the ear, or symptoms that worsen after 48-72 hours of treatment, as these require prompt medical attention 1. Your child should start feeling better within 2-3 days of beginning antibiotics.
Complete the full course of antibiotics to ensure the infection is completely cleared and to prevent antibiotic resistance. If your child's symptoms do not improve within 3 days or if you have any concerns about their condition, follow up with your doctor. It is also important to note that some children may experience persistent symptoms after 48-72 hours of initial antibacterial treatment, and in such cases, the clinician may consider changing the antibiotic 1. However, the decision to change antibiotics should be made on a case-by-case basis, taking into account the severity of symptoms and the potential risks and benefits of alternative treatments.
In general, the optimal duration of therapy for patients with AOM is uncertain, but completing the full course of antibiotics as prescribed is crucial to ensure the infection is completely cleared and to prevent antibiotic resistance 1. By following these guidelines and closely monitoring your child's condition, you can help ensure the best possible outcome and minimize the risk of complications.
From the FDA Drug Label
To minimize the potential for gastrointestinal intolerance, amoxicillin should be taken at the start of a meal. Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained For Ear/Nose/Throat infections, the recommended dosage for pediatric patients aged 3 months and older is 500 mg every 12 hours or 250 mg every 8 hours for mild/moderate infections, and 875 mg every 12 hours or 500 mg every 8 hours for severe infections.
The discharge instructions for a child diagnosed with left otitis media starting amoxicillin are to:
- Take the medication at the start of a meal to minimize gastrointestinal intolerance
- Continue treatment for at least 48 to 72 hours after the patient becomes asymptomatic
- Follow the recommended dosage for Ear/Nose/Throat infections, which is 500 mg every 12 hours or 250 mg every 8 hours for mild/moderate infections, and 875 mg every 12 hours or 500 mg every 8 hours for severe infections 2
From the Research
Discharge Instructions for a Child Diagnosed with Left Otitis Media Starting Amoxicillin
- The child should take the prescribed dose of amoxicillin as directed by the physician, which is usually administered twice or three times daily 3.
- The treatment course typically lasts for 7-10 days, but the exact duration should be determined by the healthcare provider.
- It is essential to complete the full course of antibiotics, even if the child's symptoms improve before finishing the medication 4, 5.
- The child's symptoms, such as ear pain, fever, and irritability, should be monitored and reported to the healthcare provider if they worsen or do not improve within 48-72 hours of starting treatment 4, 6.
- Pain management is crucial in treating otitis media, and the healthcare provider may recommend over-the-counter pain medications, such as acetaminophen or ibuprofen, to help alleviate the child's discomfort 4, 5.
- Follow-up appointments with the healthcare provider are necessary to assess the child's response to treatment and to monitor for potential complications, such as treatment failure or recurrence of symptoms 7.
- Parents or caregivers should be aware of the potential side effects of amoxicillin, such as diarrhea, vomiting, or rash, and report any concerns to the healthcare provider 6, 7.
- To prevent future episodes of otitis media, the healthcare provider may recommend measures such as: