Acute Otitis Media Empiric Therapy 

Updated: Dec 11, 2014
  • Author: Brenda L Natal, MD, MPH; Chief Editor: Thomas E Herchline, MD  more...
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Empiric Therapy Regimens

The preferred antibacterial drugs should be effective against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. [1, 2, 3]

Uncomplicated acute otitis media in nonimmunocompromised adults

See the list below:

Penicillin-allergic patients:

Uncomplicated acute otitis media in immunocompromised adults

See the list below:

  • Amoxicillin-clavulanate 875 mg/125 mg PO BID or  500 mg PO TID for 10-14d or
  • Cefpodoxime 200 mg PO BID for 7-10d or
  • Cefdinir 300 mg PO BID for 7-10d or
  • Clindamycin 300 mg PO TID for 7-10d

Recurrent acute otitis media

No antibiotics within past month:

  • Amoxicillin-clavulanate 875 mg/125 mg PO BID for 7-10d or
  • Cefdinir 300 mg PO BID for 7-10d or
  • Cefpodoxime 200 mg PO BID for 7-10d or
  • Cefprozil 500 mg PO BID for 10d or
  • Cefuroxime 500 mg PO BID for 7-10d or
  • Ceftriaxone 1 g/day IM for 3d

Antibiotics within past month:

  • Ceftriaxone 1 g/day IM for 3d or
  • Clindamycin 300 mg PO TID for 7-10d

Chronic otitis media

See the list below:

  • Referral to a specialist to rule out chronic otomastoiditis or cholesteatoma in setting of chronic otitis media