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ALGORITHM OF ACUTE OTITIS MEDIA

ACUTE OTITIS MEDIA

Take History Physical Examination

Low probability of AOM? High probability of AOM?

Observation Protocol
The tympanic membrane Bulging of the
did not bulging tympanic membrane
Recover Unhealed

First –Line Antibiotics* Myringotomy

Unhealed Recover

Second –Line Antibiotics Follow up

Information :
Unhealed Not Recurrent Recurrent**
* Different dose for low and high risk
** The patient is referred to an ENT
Specialist Third –Line Antibiotics Three episodes of AOM in 6 months
Four episodes of AOM in 12 months
Unhealed**
Prophylactic Antibiotics

Myringotomy, Grommet, Adenoidektomy

Evaluation

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