The Center For Disease Dynamics, Economics & Policy

Acute Otitis Media

Clinical definition:

Acute infection and inflammation of the middle ear. Common symptoms include ear pain and difficulty hearing. Common bacterial etiologies include S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, Group A Streptococcus sp.


Preferred antibiotic choice(s)
Drug Formulation Dosage Duration
Amoxicillin (PO) Powder for oral liquid: 125 mg (as trihydrate)/5 mL; 250 mg (as trihydrate)/5 mL; Solid oral dosage form: 250 mg; 500 mg (as trihydrate) 500 mg 8 hourly 5 days
Alternative antibiotic choice(s)A
Amoxicillin + clavulanic acid (PO) Oral liquid: 125 mg amoxicillin + 31.25 mg clavulanic acid/5 mL AND 250 mg amoxicillin + 62.5 mg clavulanic acid/5 mL; Tablet: 500 mg (as trihydrate) + 125 mg (as potassium salt) 500 mg of amoxicillin component 12 hourly 5 days
In case of confirmed drug allergy or medical contraindication
Azithromycin (PO) Capsule: 250 mg; 500 mg (anhydrous); Oral liquid: 200 mg/5 mL 500 mg daily 3 days



A. If patient has received antibiotics in the past month, use amoxicillin-clavulanic acid in preference to amoxicillin.