First-line Treatment
Amoxicillin 80-90 mg/kg/day is the first line of treatment. Its administration ranges from five to seven days. Ceftriaxone 50 mg/kg recommended for children that cannot use amoxicillin it is also recommended for patients who have compliance issues. In instances where diagnosed children have tympanostomy tubes, ciprofloxacin may be used based on this regime 0.3%/dexamethasone 0.1% otic solution for seven days. Another option is Ofloxacin otic solution where five drops are administered for ten days.
Second-line Treatment
In cases of penicillin allergies under non – type-1 hypersensitivity Cefdinir 14 mg/kg/day is recommended for five to ten days. Cefpodoxime 10 mg/kg/day can also be used for over a similar timespan. However, for type-1 hypersensitivity, Azithromycin 10 mg/kg/day can be administered for a maximum of three days. Clarithromycin 15 mg/kg/day is another viable option whose time span ranges from five to ten days.
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Evidence-Based Practice
The growth and development of children are often riddled with a lot of challenges, key among them being diseases and infections. It is reported that many children get ear infections that come about as a result of bacteria or viruses. The point of occurrence for most of these ear infections tends to be within the middle year as we as behind the eardrum. First off, antibiotics do not quell the pain; secondly, they are not effective against viruses and third and most importantly, most bacterial infections tend to clear on their own in a matter of days.
The immediate response to ear infections in children should include the administration of analgesic. If the symptoms are persistent, a dosage of Amoxicillin 80 to 90 mg/kg can be administered on a daily basis. It is, however, crucial to rule out any allergies to penicillin. The persistence of symptoms pertinent to ear infections ear infections should warrant further reexamination as well as the administration of second-line modes of treatment. Anatomic damage, language delay and hearing loss following earaches should be cause for great concern. In such an incidence it is vital to refer the child to an otolaryngologist.
Otitis media is a common issue among pediatricians, to the extent that up to 80% of children get ear infection by the time they turn two. While antibiotics have been effective in curbing the condition for years, it imperative to consider the greater public health challenge that is brought as a result of reliance on antibiotics. According to Ramakrishnan, Sparks, & Berryhill, (2007), otitis media receives the highest prescription of antibiotics in the United States, an element that is evidenced by the $3 billion that was spent in the treatment of the disease back in 1995. A number of factors play into the prevalence of ear infections, including environmental, immunologic as well as genetic factors.
From a bigger picture, however, antibiotics continue to present a huge public health challenge in the form of antibiotic-resistant bacteria. One of the management approaches that has been used to this extent is minimizing the antibiotic therapy. It is advisable to limit the use of antibiotics to children with severe symptoms of otitis media and who are six months an older. The fact that most ear infections clear out after a few days means that a wait-and-see approach can be considered all to curb antibiotic resistance. However, in taking the observation approach, it is paramount for the development of alternative appropriate management approaches if symptoms persist beyond 48 to 72 hours.
In the absence of any allergies, it is recommended that physicians begin with a high dose of amoxicillin. The advantages of amoxicillin are numerous. First off, it is a low-cost drug, meaning it is readily available for use. Secondly, it is highly effective and has a very acceptable taste even for children. More importantly, however, is the fact that it has a narrow microbiologic spectrum. Antibiotics come with a fair share of side effects. In this case, therefore, it is prudent to consider the medications and regimens that are administered right from childhood. Vomiting and diarrhea are among the most notable symptoms that have been linked to this particular medication (Harmes et al. 2013). Another major side effect of the use of antibiotics is that they have a tendency to destroy all forms of bacteria and this could include the bacteria that are beneficial to the body. One of the core principles that is observed in the administration of antibiotics is that prescribing practices have to be driven by in-depth consideration of each case by analyzing both the benefits and harm of the prescribing antibiotics. Acknowledging the urgency that arises from responsibility to meet the needs of a patient is perhaps the best perspective that can guide the decision-making process regarding the use of antibiotics among children.
The pressure of the parent, child and the public healthcare system as a whole can sometimes be overwhelming to a caregiver; however, they are the sole responsibility of making an accurate diagnosis or make appropriate referrals. The health and economic consequences of these decisions can be burdening to the caregiver; however, the primary goal should be the alleviation of pain, before the anticipation of a symptomatic response. A key point worth reiterating is that fevers, otalgia, and irritability often resolve within three days of the onset of antibiotic therapy. Any failure in treatment should be followed by immediate consideration of an increased dosage of amoxicillin or consideration of alternative approaches.
The importance of increased discourse regarding antibiotics is that there is a growing global trend of antimicrobial resistance. Ultimately, it is up to the public health system to ensure that such issues are contained before they expand. Increasing antimicrobial resistance translates to higher prevalence’s of treatment failures following the administration of cheap and readily available antibiotics (Harmes et al. 2013). The problem is further magnified by the fact that most of bacterial are contagious, this, therefore, means greater efforts and resources have to be utilized in combating prolonged illnesses and infectious diseases. Not only are healthcare costs increase, but there is also an aspect of adverse health at risk that must be managed properly to ensure effectiveness and efficiency.
From a global perspective, huge strides have been made up until the medical efficiencies of the twenty-first century. In this case, therefore, it is the primary responsibility of each caregiver to attend to their duties with the greatest attention realizing that while the task at hand seems gigantic, simple solutions like effective communication lines go a long way in enhancing the efficiency of medical systems around the world. It is imperative for governments and international organizations to cooperate to ensure efficient coordination is achieved. Ultimately, it by learning from previous experiences that such great growth has been realized. By replicating this philosophy to the healthcare sector, meaningful strides will be realized not just regarding dealing with a microorganism, but dealing with the pertinent challenges of the healthcare system as a whole.
It is by taking a holistic consideration of daily decisions that are made in the healthcare system, being fully aware of the intricate relationship they possess and the impact they can evoke if left unattended. This is perhaps one of the ways that the global public healthcare system can resolve some of the most vital challenges it faces. Healthcare costs and communication inefficiencies can be minimized through increased collaboration in information sharing. The front line against most infectious diseases is often time, and by establishing effective communication lines, not only are healthcare costs being minimized, but also that greater advancements and strides are being realized in regards to healthcare effectiveness as well as the realization of sustainable development goals of healthcare.
References
Harmes, K. M., Blackwood, R. A., Burrows, H. L., Cooke, J. M., Van Harrison, R., & Passamani, P. P. (2013). Otitis media: diagnosis and treatment. Children , 100 (8), 10.
Ramakrishnan, K., Sparks, R. A., & Berryhill, W. E. (2007). Diagnosis and treatment of otitis media. Am Fam Physician , 76 (11), 1650-8.
