Our 5 year old patient has been diagnosed with right acute serous otitis media
Our 5 year old patient has been diagnosed with right acute serous otitis media
MondayMay 8 at 12:35pm
Hello Professor and Fellow Classmates,
Please see my attached prescription for discussion.
Our 5 year old patient has been diagnosed with right acute serous otitis media. After review of our patient’s allergies, documented as NKDA relevant, I would prescribe amoxicillin. Our patient weighs 42 pounds, and this translate into 19.0509 kg. I would prescribe for 40-45mg/kg twice a day for 10 days.
855mg needed twice a day
Amoxicillin suspension 400mg/5ml=2.1 ml twice a day
When antibacterial drugs are indicated, high-dose amoxicillin is the treatment of choice (Table 89.3). Benefits of amoxicillin are efficacy, safety, low cost, acceptable taste, and narrow microbiologic spectrum. The duration of treatment ranges from 5 to 10 days, depending on patient age and illness severity (Burcham & Rosenthal, 2023).
Standard treatment; All children with AOM should receive pain medication, and some should receive antibiotics. Prescribing antibiotics for all children should be discouraged because most (over 80%) of AOM episodes resolve spontaneously within a week. If antibiotics are prescribed routinely, most recipients will be taking drugs they don’t really need. This generates unnecessary expense and, worse yet, puts children at needless risk for adverse drug effects, increases their risk for recurrent AOM, and accelerates the emergence of antibiotic-resistant bacteria(Burchaum & Rosenthal, 2023).
I would suggest over the counter pain mediation for the first 2-3 days of antibiotic therapy to control the fever, and assist with pain relief for the patient. I would also consider ear drops for pain relief.
I would recommend the following;
Give acetaminophen or ibuprofen for pain. Avoid aspirin in children. Demonstrate administration of otic analgesics if prescribed.
• Symptoms should start to improve within 2 days to 3 days. If this does not occur or if the symptoms increase in severity, return to the clinic.
• If antibiotics are prescribed, take exactly as ordered. (Burchum & Rosenthal, 2023).
I would focus education around follow up instructions, follow up in 14-20 days. Instructing that if symptoms worsen to return sooner. I would also incorporate antibiotic teaching, possible side effects, and to take the full course. I would encourage questions about diagnosis and treatment.
References:
Burchum, J., & Rosenthal, L. D. ([Insert Year of Publication]). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants (2nd ed.). Elsevier Health Sciences (US). https://online.vitalsource.com/books/9780323554954Links to an external site.
5 hours ago
Collapse SubdiscussionTalar Sepetjian
MondayMay 8 at 12:28pm
The patient was prescribed Amoxicillin 500 mg BID for 5 days, because of her ear infection. Amoxicillin is an antibiotic that can be used to treat certain types of infections caused by bacteria. It is critical to teach the parent how to give the patient the medication. It is important to follow instructions, and to continue medication until the prescribed medication is done (unless patient has adverse effect). Giving the patient amoxicillin at the same time everyday will ensure no dose will be skipped. If you missed the dose, you can take it as soon as you remember, unless if it is close to the time of the next dose, just skip the missed dose (“Amoxicillin,” n.d.). Do not give two doses to make up for one missed dose. Amoxicillin can be taken orally with or without food. If patient has stomach upset, give the patient food with medication.
Some side effects include diarrhea, stomach cramps, bloating, upset stomach, and vomiting. Call provider or take child to emergency if she has: “severe skin rash, hives, trouble breathing, wheezing, shortness of breath, swelling of face/lips/tongue/throat, unusual tiredness or weakness, a new fever or a fever that does not get better, severe stomach pain, severe watery diarrhea, severe vomiting” (“Amoxicillin,” n.d.). Amoxicillin will start fighting your infection soon after you start taking it, and patient should start to feel better within 2-3 days. Even if patient starts feeling better, do not stop taking prescribed medication.
Reference:
Amoxicillin. AboutKidsHealth. (n.d.). https://www.aboutkidshealth.ca/Article?contentid=73&language=English#:~:text=Pick%20a%20time%20that%20is,well%20and%20thoroughly%20before%20swallowing.
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