Final answer:
The recommended first-line treatment for 2-year-old Myles, diagnosed with acute otitis media and without recent antibiotic usage or fever, is a high-dose of amoxicillin. Alternative antibiotics may be considered if there are concerns about resistance or recent antibiotic treatment.
Step-by-step explanation:
Myles is a 2-year-old who has been diagnosed with acute otitis media (AOM), a common middle ear infection among young children. He is currently afebrile and has no recent history of antibiotic (ABX) treatment. The first-line treatment for otitis media, especially for a patient like Myles who has not recently received antibiotics, is typically a high-dose of amoxicillin. This antibiotic is preferred due to its effectiveness against common pathogens that cause AOM as well as its safe profile in children. If resistance concerns are present or if there is a history of recent antibiotic use, alternative options like macrolides or cephalosporins may be considered.
Diagnosis of AOM generally does not require laboratory testing and is made based on clinical signs and symptoms such as ear pain bulging of the tympanic membrane and in some cases, fever or nausea. Preventative strategies include vaccination with the pneumococcal conjugate vaccine (PCV13) to reduce the incidence of AOM and the influenza vaccine to decrease the risk of secondary infections leading to AOM. However while there is a vaccine for the invasive serotype B of H. influenzae, it does not impact the incidence of H. influenzae AOM.