Case Study 1- Otitis Media

Case Study 1- Otitis Media

Summary of the Case Study

The case study is about a five-year-old male who presented with features of otitis media, including ear pain, cough, and fever. The patient was initiated on Amoxycillin but did not respond, thence put on Amoxycillin/Clavulanate. There was a response, but the patient still presented with the features outlined above with an erythemic eardrum. This paper seeks to discuss the potential treatment for otitis media, the antibiotics of choice, the prescription, and the teaching of the parents regarding the patient’s treatment plan.

The Potential Treatments for This Child’s Diagnosis

Otitis media, characterized by middle ear inflammation or infection, necessitates prompt antibiotic treatment upon diagnosis to avert complications. Initially, high-dose amoxicillin or cephalosporin is recommended, but if a tympanic membrane perforation is evident, the preferred approach shifts to topical antibiotics, specifically ofloxacin. Non-response to high-dose amoxicillin may prompt the use of amoxicillin-clavulanic acid  (Danishyar & Ashurst, 2023). For recurrent otitis media impacting hearing and quality of life, myringotomy, a surgical procedure involving a small incision in the eardrum and the placement of tympanostomy tubes, is considered, aiming to prevent fluid accumulation and reduce the frequency of ear infections while maintaining hearing ability.

Antibiotics That Should Be Given for This Patient’s Diagnosis

In the described case study, the anticipated positive response to amoxicillin or amoxicillin-clavulanic acid did not manifest in the pediatric patient, as evidenced by the persistent presence of fever and an erythemic tympanic membrane. The antibiotic of choice for the patient would be intravenous Ceftriaxone. Being a broad-spectrum antibiotic, Ceftriaxone would address potential resistance or insufficient efficacy observed with the previous medications. In the event of continued non-response to Ceftriaxone, the recommended next step in the treatment protocol involves the use of clindamycin as the subsequent therapeutic option (Chang Pitter et al., 2022). This sequential approach underscores the importance of tailoring the treatment strategy based on the individual patient’s response and the specific characteristics of the infection, aiming for an adjusted and effective management plan.

Duration of the Antibiotic Prescription

To ensure a more effective response, it’s important to administer antibiotics according to the recommended duration. As outlined in Chang Pitter et al. (2022), the guidelines suggest that Ceftriaxone should be given at a dosage of 50mg per kilogram of body weight daily for three days. It’s crucial, however, to adhere to the maximum dose of 200mg per dose and avoid exceeding this limit. Following these prescribed, dosing recommendations is essential in optimizing the antibiotic’s efficacy while maintaining safety considerations.

Teachings I Would Give This Child’s Parents on the Prescription

Given that Ceftriaxone is administered through intravenous injection, it necessitates hospitalization for effective treatment. It’s crucial to communicate this plan to the parents, informing them of the intention to hospitalize the child for three days to facilitate the administration of the intravenous medication. The educational aspect should encompass an explanation of why an intravenous medication is deemed necessary, attributing it to the failure of the child to respond adequately to oral antibiotics. The anticipated outcomes of this approach would include the reduction of fever and alleviation of other associated symptoms. Emphasizing the importance of adhering to the prescribed treatment plan is paramount during the teaching process. Furthermore, parents should be encouraged to maintain follow-up appointments after the hospitalization to ensure continued monitoring and appropriate adjustments to the treatment as needed.

Correct Prescription for the Prescribed Antibiotic for this Patient

Prescription: I.V Ceftriaxone 950mg BD for three days

A proper prescription is fundamental in guiding the administration of medication, ensuring clarity and accuracy in the treatment plan. It should encompass key details such as the route of administration, the specific name of the medication, the recommended frequency, and the duration of the treatment. In the case of Ceftriaxone, a correct prescription would provide explicit instructions, specifying “Intravenous Ceftriaxone” to indicate the route of administration. The dosage is also crucially defined, stating “965mg twice daily,” signifying the amount of the medication and the frequency of administration. Furthermore, the prescription outlines the duration of the treatment, which, in this instance, is “for three days.” This comprehensive prescription not only ensures the patient receives the right medication but also provides healthcare professionals and caregivers with clear guidelines for administering the treatment appropriately and effectively.

References

Chang Pitter, J. Y., Zhong, L., Hamdy, R. F., Preciado, D., Behzadpour, H., & Hamburger, E. K. (2022). Ceftriaxone use for acute otitis media: Associated factors in a large U.S. primary care population. International Journal of Pediatric Otorhinolaryngology, 160(111211), 111211. https://doi.org/10.1016/j.ijporl.2022.111211

Danishyar, A., & Ashurst, J. V. (2023). Acute otitis media. StatPearls Publishing.

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://www.ncbi.nlm.nih.gov/books/NBK470332/

Discussion Prompt

Part 1:
Choose a condition from the following case studies (Week 4 Case Studies). You may work in small groups of up to 3 students if desired.

Part 2: Answer the following questions

Discuss what are the potential treatments for this child’s diagnosis
What antibiotic/s should be given for this patient’s diagnosis?
How long should you prescribe the chosen antibiotic?
What teaching would you give this child’s parents on the prescription?
Write out a correct prescription for the antibiotic you are going to prescribe for this patient. (Be sure to include all elements needed for a correct prescription)
Expectations

Initial Post:

Length: A minimum of 500 words, max of 1000, not including references or attachments
Citations: At least one high-level scholarly reference in APA from within the last 5 years