What is the first line treatment of acute otitis media?

Acute otitis media is caused by viral or bacteria most commonly Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis. There are many antibiotics that are used to kill these bacteria the most common is amoxicillin. Amoxicillin has a long record of safety; however there has been an increase in resistance from some bacteria. To counter this resistance, amoxicillin is often prescribed in higher doses in an effort to combat these bacteria.

Many other antibiotics may also be prescribed – each has their benefits. Some common drugs include azithromycin (Zithromax), clarithromycin (Biaxin), and amoxicillin-clavulanate (Augmentin), or cefdinir (Omincef). Some bacteria may be resistant to one antibiotic and not another therefore you may have to change your antibiotics if the infection does not improve.

Otitis media with effusion is the presence of fluid behind the eardrum without being infected. Often the fluid may be present without you or your child even noticing, especially after a resolving ear infection. In this case, you may just observe until the fluid goes away. If the fluid is causing pain, pressure, fullness, hearing loss, or it does not go away you may be prescribed a decongestant or nasal spray to help open your Eustachian tube to “drain” the fluid more quickly. If fluid persists for more than 3 months, pressure equalization tubes are usually required