A 3-year-old child has had one episode of acute otitis media (AOM) 3 weeks prior with a normal tympanogram just after treatment with amoxicillin. In the clinic today, the child has a type B tympanogram, a temperature of 102.5°F, and a bulging tympanic membrane. What will the primary care pediatric nurse practitioner order?

Question

Quizplus · Accepted Answer

The child's presentation indicates a new episode of AOM and the presence of a bulging tympanic membrane suggests a middle ear effusion with possible bacterial infection. The type B tympanogram further supports the diagnosis. The child should be treated with a higher dose of antibiotics than previously prescribed due to the recent AOM episode and potential for bacterial resistance. Amoxicillin-clavulanate is the preferred first line treatment for AOM in children with recent antibiotic use or with severe symptoms such as high fever and a bulging tympanic membrane. Tympanocentesis or IM ceftriaxone would not be necessary at this time.

A 3-Year-Old Child Has Had One Episode of Acute Otitis