From the Guidelines
For a 5-year-old child with acute otitis media (AOM), the recommended duration of amoxicillin treatment is typically 5-7 days, as the optimal duration of therapy is uncertain, but this duration is considered adequate for most uncomplicated cases and helps minimize antibiotic resistance while ensuring effective treatment 1.
Key Considerations
- The standard dosage of amoxicillin is 80-90 mg/kg/day divided into two doses (given every 12 hours) 1.
- For example, if the child weighs 20 kg, they would receive approximately 800-900 mg twice daily.
- If the child has severe symptoms, risk factors for resistant organisms, or treatment failure with standard dosing, high-dose amoxicillin (90 mg/kg/day) or amoxicillin-clavulanate may be preferred 1.
Important Reminders
- It's essential to complete the full course of antibiotics even if symptoms improve before the medication is finished.
- Parents should ensure the child stays well-hydrated during treatment and should contact their healthcare provider if symptoms worsen or don't improve after 48-72 hours of antibiotic therapy, as this might indicate a need for a different antibiotic.
Treatment Failure
- If there is no improvement after 48-72 hours of antibiotic therapy, alternative treatments such as amoxicillin-clavulanate, cefdinir, cefuroxime, or cefpodoxime may be considered 1.
- In cases of treatment failure, it's crucial to reassess the patient and consider other potential causes of symptoms or complications.
From the Research
Duration of Amoxicillin Course for AOM in 5-Year-Old
- The duration of amoxicillin course for Acute Otitis Media (AOM) in children is typically 7 to 10 days 2.
- A study comparing clarithromycin and amoxicillin suspensions for the treatment of AOM in children 1 to 12 years of age inclusive, used amoxicillin suspension in a dose of 20 mg/kg (maximum, 750 mg) twice daily for 7 to 10 days 2.
- Another study compared the safety and efficacy of clarithromycin and amoxicillin/clavulanate in the treatment of AOM in patients ages 6 months to 12 years, and used amoxicillin/clavulanate for 10 days 3.
- Consensus recommendations for the management of AOM suggest that amoxicillin at conventional or high doses (80-90 mg/kg/day) remains an appropriate choice for first-line therapy for AOM, but do not specify the exact duration of the course 4.
- A systematic review of the efficacy of antimicrobials or placebo compared to amoxicillin-clavulanate in children with AOM, included studies with various durations of treatment, but did not provide a specific recommendation for the duration of amoxicillin course 5.
- Another systematic review of acute otitis media and antibiotics, included studies with treatment durations ranging from 5 to 10 days, but did not provide a specific recommendation for the duration of amoxicillin course 6.