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Acute Otitis Media ( Middle Ear Pain, Infection ) : Causes, Symptoms, Diagnosis, Treatment, Risk Factors

Acute Otitis Media ( AOM ) - Ear Pain

Acute Otitis Media ( AOM ) or Middle Ear disorder or Ear Pain characterized by Moderate to severe onset middle ear  sever pain, Ear effusion, Physical evidence of the middle ear inflammation.

Causes :

Childhood bacterial infection
Sinus Infection
Sore throat
Respiratory Infections.

Symptoms :

  • Ear pain ( Less than 48 hours )
  • Swelling
  • Edema
  • Pus Discharge form ear
  • Redness
  • Fever
  • Irritability
  • Bulging of tympanic membrane

Risk Factors :

Age : Younger
Upper respiratory tract infections
Family history of recurrent acute otitis media
Exposure to environmental smoke
Respiratory Irritants
No breast feeding
Pacifier use
Craniofacial abnormalities
Gastroesophageal reflux

Diagnosis :

1) Physical Examination : Using otoscopy visualized the ear parts.
2) Symptomatology : Without otoscopic findings of inflammation.
3) Investigations :
     Most cases can be diagnosed clinically. Such as
  • FBC
  • CRP
  • Blood Culture  and Fluid culture : If any discharge present and if any signs of sepsis. Fluid culture has to be taken before starting Antibiotic Therapy


Diagnosis established by physical examination findings and presence of symptoms

Antibiotic Therapy :

First line Antiboitics
Initially firsit line antibiotics to be start with high dose.

1. Tab : Amoxycilin 625mg
Adult Dose : 625 mg in two times per day for 3 days or 5 days or 7 days or 10 days
Note : Before taking check for allergies.

2. If symptoms not cured after 3 days of treatment administer ceftriaxone, clindamycin, tympanocentesis

Children Dose : 90 mg per kg ay in two divided doses. It is the first choice for initial antibiotic therapy in Children with AOM.

Second line Antiboitics Therapy

2. Ciprofloxocin Ear Drops
Dosage : Ciprofloxocin Ear drops 3 times or 4 times per day
Note : Before taking check who are allergic to pencillin.

Pain Management :

Adequate analgesia. Use NSAIDs
Analgesics are recommended for symptoms of ear pain, fever and irritability. Analgesics are particularly important at bedtime ( Due to pain disrupted to sleeping pattern )
1. Acetaminophen
2. Ibuprofen
1. Ketrol DT
2. Paracetamol

Note : Check for Kidney disease

Swelling :

1. Dexamethasone ear drops

Procedure : 

Ear Irrigation : Ear irrigation is a procedure to clear the fluids of inner ear. It is performed by the physician.

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