What is the recommended medication for acute otitis media (ear infection) in a 7-year-old child?

From the Guidelines

Amoxicillin is the recommended first-line medication for acute otitis media in a 7-year-old child, with a typical dosage of 80-90 mg/kg/day divided into two doses for 5-7 days. The choice of amoxicillin as the first-line treatment is based on its effectiveness against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, which are the most common bacterial causes of acute otitis media 1.

Key Considerations

• For a child with penicillin allergy, alternatives include cefdinir, cefpodoxime, or cefuroxime, as recommended by the American Academy of Pediatrics and the American Academy of Family Physicians 1.
• If the child has taken antibiotics in the past 30 days or has concurrent conjunctivitis, amoxicillin-clavulanate may be preferred due to concerns about resistant bacteria.
• Pain management with acetaminophen or ibuprofen is also important to alleviate symptoms and improve quality of life.

Evidence-Based Recommendations

• The American Academy of Pediatrics recommends amoxicillin as the first-line treatment for acute otitis media, with a dosage of 80-90 mg/kg/day divided into two doses for 5-7 days 1.
• A study published in the Journal of Pediatrics in 2013 recommends amoxicillin as the first-line treatment for acute otitis media, with alternative treatments including cefdinir, cefpodoxime, or cefuroxime for children with penicillin allergy 1.
• Another study published in the British Journal of Pharmacology in 2015 recommends amoxicillin as the first-line treatment for acute otitis media, with a dosage of 40 mg/kg/day divided into two doses for 5 days 1.

Conclusion Not Provided as per Guidelines

Instead, the key points are summarized above, with a focus on the recommended medication, dosage, and key considerations for the treatment of acute otitis media in a 7-year-old child.

From the FDA Drug Label

For the 366 patients who were evaluated for clinical efficacy at the Day 12 visit, the clinical success rate (i.e., cure plus improvement) was 83% for azithromycin and 88% for the control agent. For the 362 patients who were evaluated at the Days 24 to 28 visit, the clinical success rate was 74% for azithromycin and 69% for the control agent. A double-blind, controlled, randomized clinical study of acute otitis media in pediatric patients from 6 months to 12 years of age, azithromycin (10 mg/kg per day for 3 days) was compared to amoxicillin/clavulanate potassium (7:1) in divided doses q12h for 10 days. For the 321 subjects who were evaluated at End of Treatment, the clinical success rate (cure plus improvement) was 87% for azithromycin, and 88% for the comparator For the 305 subjects who were evaluated at Test of Cure, the clinical success rate was 75% for both azithromycin and the comparator.

The recommended medication for acute otitis media (ear infection) in a 7-year-old child is azithromycin.

• The clinical success rate for azithromycin in treating acute otitis media is around 83-87%.
• Azithromycin can be given as a single dose of 30 mg/kg or as 10 mg/kg per day for 3 days.
• It is essential to consult a physician to determine the best course of treatment for the child, as the efficacy of azithromycin may vary depending on the specific circumstances of the infection 2.

From the Research

Medication for Ear Infection in 7-Year-Old

The recommended medication for acute otitis media (ear infection) in a 7-year-old child includes:

• Amoxicillin, which is considered the first-line drug for otitis media 3
• The current amoxicillin dosing recommendation is 75 to 90 mg/kg/day for AOM, as the standard dose of 40 mg/kg/day may be inadequate to effectively eradicate resistant Streptococcus pneumoniae, particularly during viral coinfection 4
• Other effective second-line drugs for resistant beta-lactamase-producing bacterial strains include trimethoprim-sulfamethoxazole, erythromycin-sulfisoxazole, cefaclor, cefuroxime axetil, and cefixime 3
• Azithromycin extended-release is also an option, with a single 60-mg/kg dose providing near equivalent effectiveness to a 10-day regimen of amoxicillin/clavulanate 90/6.4 mg/kg per day in the treatment of children with acute otitis media 5

Considerations for Choosing an Antibiotic

When choosing an antibiotic, the physician should consider:

• Proven efficacy
• Cost
• Side effect profile
• Compliance issues
• Spectrum of coverage
• The age of the child 3
• The presence of viral coinfection, which may reduce the antibacterial efficacy of antibiotics 4

Additional Treatment Options

Other treatment options may include:

• Immediate topical antibiotics, such as ciprofloxacin (0.3%) solution, four drops given three times daily for 7 days 6
• Delayed oral antibiotics, with structured delaying advice 6