Amoxicillin Treatment Regimens for Acute Otitis Media and the Impact on Penicillin-Resistant Streptococcus pneumoniae

Thesis (M.Nurs.), College of Nursing, Washington State UniversityWith increasing prevalence of penicillin-resistant Streptococcus pneumoniae, treatment of acute otitis media is becoming more complicated. Current standards of antibiotic treatment are being questioned as some research indicates that low dose amoxicillin (50 mg/kg/day) and a long treatment duration (longer than 5 days) may encourage the proliferation of resistant strains. The amoxicillin dose must be sufficiently high to reach the minimum inhibitory concentration of resistant strains and the duration of treatment should be reduced to avoid a prolonged antibiotic selective environment. A dose of 75-90 mg/kg/day, to a maximum of 2-3gm in 24 hours, for 5 days is recommended for treatment of acute otitis media in children older than 2 years