What medication and dose is recommended for treating suspected otitis media (ear infection) in adults?

From the Guidelines

For suspected otitis media in adults, I recommend amoxicillin as the first-line treatment, with a dosage of 80 to 90 mg per kg per day, as it is generally effective against susceptible and intermediate resistant pneumococci, and has a narrow microbiologic spectrum, as stated in the guideline by the American Academy of Pediatrics and the American Academy of Family Physicians 1. When considering treatment options, it's essential to note that the choice of medication should be based on the anticipated clinical response and the microbiologic flora likely to be present.

• Amoxicillin is a suitable option due to its effectiveness, safety, and affordability, as well as its acceptable taste.
• If the patient is allergic to amoxicillin and the allergic reaction is not a type I hypersensitivity reaction, alternative options such as cefdinir, cefpodoxime, or cefuroxime can be considered. Key points to consider when treating suspected otitis media in adults include:
• The optimal duration of therapy is uncertain, and treatment should be individualized based on the patient's response and clinical presentation.
• It's crucial to weigh the benefits and risks of antibacterial treatment, as the preponderance of benefit over risk supports the use of amoxicillin in sufficient doses, as noted in the guideline 1.
• The patient's clinical response and potential allergic reactions should be closely monitored during treatment.

From the FDA Drug Label

The usual adult dose is one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 250 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours For more severe infections and infections of the respiratory tract, the dose should be one 875 mg/125 mg amoxicillin and clavulanate potassium tablet every 12 hours or one 500 mg/125 mg amoxicillin and clavulanate potassium tablet every 8 hours.

The recommended medication and dose for treating suspected otitis media (ear infection) in adults is amoxicillin-clavulanate. The dose is:

• 500 mg/125 mg every 12 hours
• 250 mg/125 mg every 8 hours For more severe infections, the dose can be increased to 875 mg/125 mg every 12 hours or 500 mg/125 mg every 8 hours 2.

From the Research

Medication for Treating Suspected Otitis Media in Adults

• The provided studies do not specifically address the treatment of otitis media in adults, but rather focus on the treatment of acute otitis media in children.
• However, based on the information provided, high-dose amoxicillin (80 to 90 mg per kg per day) is the recommended antibiotic for treating acute otitis media in patients who are not allergic to penicillin 3, 4, 5.
• Alternative agents, such as amoxicillin/clavulanate, cefuroxime axetil, and intramuscular ceftriaxone, may be used in cases of clinically defined treatment failure after 3 days of therapy 5.
• Azithromycin has also been shown to be effective in treating acute otitis media in children, with a 5-day course of once daily azithromycin being comparable to a 10-day course of three times daily amoxicillin/clavulanate 6.

Dosage and Administration

• The recommended dosage of amoxicillin for treating acute otitis media is 80 to 90 mg per kg per day, divided into three doses per day 3, 4, 5.
• The duration of treatment is typically 10 days, but may vary depending on the specific circumstances of the patient 3, 4, 5.

Limitations of the Evidence

• The provided studies do not address the treatment of otitis media in adults, and therefore the recommendations may not be directly applicable to this population.
• Further research is needed to determine the most effective treatment for otitis media in adults.