Otitis media

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Cefdinir, Cefuroxime, Cefpodoxime and Ceftriaxone are recommended for treatment of otitis media in patients with penicillin allergy when allergy is not severe.

Otitis media is the most common reason antibiotic are prescribed in children. Most infections are mixed with both viral and bacterial pathogens. The most common bacterial pathogens are Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis. Group A Streptococcus is less commonly seen.

First line therapy is amoxicillin. In those with a penicillin allergy treatment options include second and third generation cephalosporins: Cefdinir, Cefuroxime, Cefpodoxime, Ceftriaxone. Unlike first generation cephalosporins there is not cross reactivity between later generation cephalosporins and penicillins and they can be used in penicillin allergic patients.


Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, Joffe MD, Miller DT, Rosenfeld RM, Sevilla XD, Schwartz RH, Thomas PA, Tunkel DE. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar;131(3):e964-99. PMID: 23439909