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<sup>13</sup> Dx: mod-severe TM bulge OR new otorrhea (not otitis externa) [B/R] OR mild TM bulge w/ either intense TM erythema or <48 h onset ear pain [C/R]. Do not dx AOM in those w/o middle ear effusion based on pneumatic otoscopy and/or tympanometry [B/R].<br><br><sup>14</sup> Definition of severe sx: mod-severe otalgia or otalgia >48 h or fever ≥39°C
<br><br><sup>15</sup> Abx duration: 2-5 yo: 7 days; ≥6 yo: 5-7 days.
<br><br><sup>16</sup> Cross-reactivity w/ cephalosporins in nonsevere PCN allergy is 0.1%.
<br><br><sup>17</sup> May offer T-tubes for recurrent AOM: either 3 episodes/6 mo or 4 episodes/1 yr, ≥1 episode in preceding 6 mo [B/O]. Xylitol 3-5x/day may be effective for prevention of recurrent AOM in children >2 yo. Home remedies/homeopathy: no controlled studies.
<br><br><sup>15</sup> Abx duration: 2-5 yo: 7 days; ≥6 yo: 5-7 days.
<br><br><sup>16</sup> Cross-reactivity w/ cephalosporins in nonsevere PCN allergy is 0.1%.
<br><br><sup>17</sup> May offer T-tubes for recurrent AOM: either 3 episodes/6 mo or 4 episodes/1 yr, ≥1 episode in preceding 6 mo [B/O]. Xylitol 3-5x/day may be effective for prevention of recurrent AOM in children >2 yo. Home remedies/homeopathy: no controlled studies.
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