Discharge Instructions for 11-Month-Old with Otitis Media on Amoxicillin
Complete the full 10-day course of amoxicillin even if your child feels better before finishing the medication, as stopping early increases the risk of treatment failure and antibiotic resistance. 1, 2
Medication Administration
- Give amoxicillin exactly as prescribed (80-90 mg/kg/day divided into 2-3 equal doses) at evenly spaced intervals throughout the day 2, 3
- Shake the suspension bottle well before each dose to ensure proper mixing 4
- Use the calibrated oral syringe provided with the medication—never use household spoons, as they are inaccurate 4
- Rinse the oral syringe after each use to prevent medication buildup 4
- Refrigeration is preferred but not required for the suspension; keep the bottle tightly closed 4
- Discard any unused suspension after 14 days from when it was mixed 4
Pain Management
- Give pain medication (acetaminophen or ibuprofen) regularly during the first 24-48 hours, even if your child seems comfortable, as pain control is essential regardless of antibiotic use 1, 2
- Continue pain medication as needed for ear discomfort 1
When to Seek Immediate Medical Attention
Return to the clinic or emergency department immediately if any of these occur:
- Worsening symptoms or no improvement within 48-72 hours of starting antibiotics (persistent fever, increased irritability, worsening ear pain) 1, 3
- New or worsening fever ≥39°C (102.2°F) after starting treatment 2, 5
- Skin rash, hives, or facial swelling, which may indicate an allergic reaction 4
- Severe diarrhea (≥3 watery stools in one day or bloody stools), which can occur even weeks after finishing antibiotics 1, 4
- Drainage from the ear (otorrhea) that develops or worsens 5
- Extreme irritability or lethargy beyond what you've already observed 2
Expected Course and Follow-Up
- Symptoms should begin improving within 48-72 hours of starting antibiotics, though complete resolution may take the full 10 days 1
- Fluid behind the eardrum (middle ear effusion) is normal after treatment and can persist for 2-8 weeks without indicating treatment failure 1
- Routine follow-up visits are not necessary for uncomplicated cases if your child improves as expected 5
- Consider a follow-up examination if your child has recurrent ear infections or if you have concerns about hearing 5
Important Warnings
- Never save leftover antibiotics for future illnesses or share them with others 4
- Antibiotics only treat bacterial infections, not viral illnesses like colds 4
- Watch for signs of yeast diaper rash (candidal infection), which can occur as a side effect of antibiotics 6
- Common side effects include diarrhea (occurs in 14-34% of children), which usually resolves after completing treatment 6