Final answer:
The first-line treatment for otitis media in a patient with a penicillin allergy involves using alternative antibiotics such as macrolides or cephalosporins. Erythromycin, clarithromycin, or azithromycin are common macrolide options, while cephalosporins can be used with caution considering the type of penicillin allergy.
Step-by-step explanation:
The first-line treatment for otitis media in patients with a penicillin allergy typically involves alternative classes of antibiotics. While high-dose amoxicillin is the first choice for treating acute otitis media (AOM), patients allergic to penicillin cannot use this option. In such cases, antibiotics from the macrolide or cephalosporin families, which are not structurally similar to penicillins and therefore less likely to cause an allergic reaction, can be used. Macrolides such as erythromycin, clarithromycin, or azithromycin may be prescribed. When prescribing cephalosporins, clinicians typically ensure that the allergy to penicillin is not of the immediate hypersensitivity type, as there is some risk of cross-reactivity. For more severe infections or resistance concerns, fluoroquinolones like levofloxacin may be appropriate.