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Acute Otitis Media — RACP Paediatrics MCQ

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HardRespiratoryAcute Otitis MediaRACP Paediatrics

A 5-month-old Indigenous Australian infant in a remote community presents with bilateral ear discharge. Examination confirms bilateral tympanic membrane perforations with mucopurulent discharge. He has had 4 episodes of acute otitis media in the past 6 months. What is the recommended antibiotic according to Australian guidelines?

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Correct answer: B — Oral amoxicillin 90 mg/kg/day for 14 days

Aboriginal and Torres Strait Islander children with acute otitis media with perforation should receive high-dose amoxicillin (90 mg/kg/day in 2 divided doses) for 14 days. This population has higher rates of AOM, more virulent organisms, and a higher risk of complications including chronic suppurative otitis media (CSOM). Standard-dose shorter courses are inadequate.

Reference: NHMRC – 2024 – Recommendations for Clinical Care Guidelines on the Management of Otitis Media in Aboriginal and Torres Strait Islander Populations