From the Research
For chronic otitis media in an adult male who last took Augmentin over six months ago, amoxicillin-clavulanate (Augmentin) remains a recommended first-line antibiotic, as supported by the most recent and highest quality study available 1. The typical adult dosage is 875 mg amoxicillin/125 mg clavulanate twice daily for 10-14 days. Since the previous course was over six months ago, resistance development to this antibiotic is less likely. Alternative options include cefuroxime 500 mg twice daily for 10 days or, if there's suspected penicillin allergy, trimethoprim-sulfamethoxazole or a fluoroquinolone like ciprofloxacin (especially if Pseudomonas is suspected) 2. It's essential to complete the full course of antibiotics even if symptoms improve earlier. The patient should follow up if symptoms don't improve within 48-72 hours, as this might indicate resistant bacteria requiring culture-directed therapy. Augmentin works well for chronic otitis media because it covers common pathogens, including beta-lactamase-producing organisms that are often responsible for persistent ear infections 3. Some key points to consider when treating chronic otitis media include:
- The importance of completing the full course of antibiotics to ensure effective treatment and prevent resistance development
- The need for follow-up if symptoms do not improve within 48-72 hours to assess for potential resistant bacteria
- The consideration of alternative antibiotics, such as cefuroxime or fluoroquinolones, in cases of suspected penicillin allergy or Pseudomonas infection
- The potential for surgical intervention, such as tympanomastoidectomy, in cases of recurrent or persistent infection 1.