Acute Otitis Media Empiric Therapy 

Updated: Jan 24, 2019
  • Author: Brenda L Natal, MD, MPH; Chief Editor: Thomas E Herchline, MD  more...
  • Print
Sections

Empiric Therapy Regimens

The preferred antibacterial drugs should be effective against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Streptococcus pyogenes and Pseudomonas pneumoniae are also listed as frequent microbiologic infections in the adult population. [1, 2, 3, 4]

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

Refer the patient to a specialist to rule out chronic otomastoiditis or cholesteatoma in the setting of chronic otitis media.

P aeruginosa and Staphylococcus aureus have been described as common causes of chronically infected ears in adults. [3]