The recommendations are not intended for treating children <6 months of age or for those with craniofacial abnormalities, immunocompromising conditions, tympanostomy tubes or recurrent acute otitis media (AOM).
Children greater than 2 years of age if no known complications: 5 days
Children less than 2 years of age, frequent, recurrent AOM, perforation or failed initially: 10 days
OR
OR
For patients who fail to respond to therapy with Amoxicillin (ie no significant improvement after 2-3 days) or present with otitis-conjunctivitis syndrome:
Dosing based on amoxicillin component
If the patient has NOT had a previous IgE mediated reaction to amoxicillin
OR
Cefuroxime axetil 15 mg/kg/dose PO BID
Maximum: 1 gram/24h
Referral to an otolaryngologist for tympanocentesis may be considered to determine the etiological organism to guide therapy.