OTITIS MEDIA CASE STUDY_(Advanced Pharmacology N5334)

Document Content and Description Below

OTITIS MEDIA CASE STUDY_(Advanced Pharmacology N5334) Case Study 1: OTITIS MEDIA Seth, a 16-month-old boy (wt. 10.5 kg) with a diagnosis of acute otitis media (AOM), is brought to his pediatrician b... ecause of ear pain, decreased appetite, decreased playfulness, and difficulty sleeping. He has had three episodes of AOM previously, the most recent episode having occurred2 weeks ago and treated with high-dose amoxicillin. He was diagnosed with bronchiolitis approximately 1 month ago and treated with symptomatic care with ibuprofen, fluids, and rest. His mother reports Seth having a 1-day history of tugging at his right ear and crying, and a 2-dayhistory of decreased appetite, decreased playfulness, and difficulty sleeping. His temperatures at home have all been elevated (39.5°C), and he has been given ibuprofen 100 mg Q 12 h × 2 doses. On physical examination, both right and left tympanic membranes (TMs) are erythematous. Left ear appears otherwise normal with normal landmarks visible. The right ear TM is bulging with limited mobility; copious cerumen and purulent fluid behind TM. The right ear landmarks are difficult to visualize and view of the umbo is obstructed. In this patient, the diagnosis of AOM is certain based on the acute onset of symptoms, signs of middle ear effusion (MEE), and signs and symptoms of middle ear inflammation, and is likely a treatment failure from the previous episode. This patient is a candidate for antibacterial therapy based on his age and severe illness (temperature above 39°C). Empiric antibiotic selection should be based on the likely causative organisms, antibiotic efficacy against resistant organisms, and patient factors such as prior antibiotic tolerance and likely patient adherence to the complete regimen. Additionally, antibiotic selection must take into account the previous treatment for a similar diagnosis 2 weeks ago [Show More]

Last updated: 1 year ago

Preview 1 out of 17 pages