Pediatric Acute Otitis Media Organism-Specific Therapy 

Updated: Dec 17, 2015
  • Author: Brenda L Natal, MD, MPH; Chief Editor: Thomas E Herchline, MD  more...
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Specific Organisms and Therapeutic Regimens

Organism-specific therapeutic regimens for pediatric acute otitis media are provided below, including those for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and viral or sterile effusion. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]

Streptococcus pneumoniae

Intermediate resistance or penicillin-susceptible:

  • Amoxicillin 80-90 mg/kg/day (maximum 3 g/24h) PO divided BID for 5-10d or
  • Ceftriaxone 50 mg/kg (maximum 1 g) IM × 1 dose

Highly resistant and severe disease with complications:

  • Vancomycin 40 mg/kg/day (maximum 4 g/24h) IV divided q6-8h for 10d

Haemophilus influenzae

See the list below:

  • Amoxicillin-clavulanate 80-90 mg/kg/day (maximum 4 g/24h) PO divided BID for 5-10d or
  • Ceftriaxone 50 mg/kg (maximum 1 g) IM × 1 dose or
  • Cefdinir 14 mg/kg/day (maximum 600 mg/24h) PO daily or divided BID for 5-10d or
  • Cefpodoxime 10 mg/kg/day (maximum 400 mg/24h) PO daily or divided BID for 5-10d or
  • Cefuroxime 30 mg/kg/day (maximum 1 g/24h) PO divided BID for 5-10d

Moraxella catarrhalis

See the list below:

  • Amoxicillin-clavulanate 80-90 mg/kg/day (maximum 4 g/24h) PO divided BID for 5-10d or
  • Ceftriaxone 50 mg/kg (maximum 1 g) IM × 1 dose or
  • Cefdinir 14 mg/kg/day (maximum 600 mg/24h) PO daily or divided BID for 5-10d or
  • Cefpodoxime 10 mg/kg/day (maximum 400 mg/24h) PO daily or divided BID for 5-10d or
  • Cefuroxime 30 mg/kg/day (maximum 1 g/24h) PO divided BID for 5-10d

Viral or sterile effusion

See the list below:

  • None