235k views
2 votes
Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the two-week recheck, his TM was still erythematous and you cannot see the landmarks. He has persistent nasal congestion, he is not sleeping at night, and he has a 101°F fever. What is the next best step for Luke?

2 Answers

2 votes

Step-by-step explanation:

Hello!

Let's solve this!

What you have to keep in mind is:

It is an obstruction of the eustachian tubes.

We have to take the following measures:

Do not breastfeed or take a bottle lying down, do it in a sitting or semi-sitting position due to tubal obstruction. Nebulizations to decongest (with physiological solution)

betamethasone 1 drop / kg 3 times a day, orally for 3 days then twice a day for three days and lie once a day two days

children's paracetamol 5cm every 8 (according to temperature)

It is a congestive catarrhal otitis media compatible with tubal obstruction (eustachian tube

at the nasal level)

User Funkenstrahlen
by
4.6k points
1 vote

Answer:

The next step is to start treatment with third generation cephalosporin combined or not with B-lactams according to the evolution of the symptoms.

User Anuraagy
by
4.2k points