From the Guidelines
For a pregnant 35-year-old with acute otitis media (AOM), the recommended dose of amoxicillin is 80 to 90 mg per kg per day, as this dosage is effective against susceptible and intermediate resistant pneumococci and has a narrow microbiologic spectrum 1. The dosage of 80 to 90 mg per kg per day is based on extrapolation from microbiologic studies and expert opinion, with a preponderance of benefit over risk.
- This option is considered safe, inexpensive, and has an acceptable taste.
- Amoxicillin is recommended as first-line therapy for AOM because it is generally effective when used in sufficient doses against susceptible and intermediate resistant pneumococci.
- A more recent study from 2013 also supports the use of high-dose amoxicillin as the first-line treatment for AOM, although it provides dosage recommendations for children 1.
- However, for adults, including pregnant women, the dosage of 80 to 90 mg per kg per day can be used as a guideline to determine the appropriate dose.
- It's essential to note that the optimal duration of therapy for patients with AOM is uncertain, but completing the full course of antibiotics is crucial, even if symptoms improve before finishing the medication.
- Patients should take the medication with or without food, though taking it with food may help reduce stomach upset.
- Amoxicillin is considered safe in all trimesters of pregnancy (pregnancy category B) and effectively targets the common bacterial pathogens involved in AOM, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
From the Research
Recommended Dose of Amoxicillin for Pregnant Women with AOM
The recommended dose of amoxicillin for a pregnant 35-year-old with acute otitis media (AOM) is not explicitly stated in the provided studies. However, the following information can be considered:
- A study published in 2003 2 recommends high-dose amoxicillin (70 to 90 mg/kg/day) as first-line therapy for AOM in children, but does not provide guidance for pregnant women.
- A study published in 2002 3 suggests that amoxicillin at conventional or high doses (80-90 mg/kg/day) remains an appropriate choice for first-line therapy for AOM, but does not specify the recommended dose for pregnant women.
Considerations for Pregnant Women
When considering the treatment of AOM in pregnant women, it is essential to weigh the benefits and risks of antibiotic therapy. The following points should be considered:
- The safety and efficacy of amoxicillin in pregnant women have not been explicitly studied in the provided evidence.
- The recommended dose of amoxicillin for pregnant women with AOM is not established, and caution should be exercised when prescribing antibiotics during pregnancy.
Alternative Treatment Options
Alternative treatment options for AOM in pregnant women may include: