Acute Otitis Media Treatments: Newborn-12 Years
ACUTE OTITIS MEDIA TREATMENTS: NEWBORN−12 YEARS 
Generic Brand Strength Form Flavor Dose
amoxicillin 125mg/5mL, 200mg/5mL, 250mg/5mL, 400mg/5mL susp raspberry-strawberry ≤3mos: Max 30mg/kg/day in 2 divided doses every 12hrs.
>3mos (<40kg): 20mg/kg/day in 3 divided doses every 8hrs. Severe: 40mg/kg/day in 3 divided doses every 8hrs.
≥40kg: 250mg every 8hrs. Severe: 500mg every 8hrs
Note: The AAP recommends 80–90mg/kg/day in divided doses (this is not an FDA-approved dose)
amoxicillin + clavulanate 200mg/28.5mg, 400mg/57mg chew tabs cherry-banana Base dose on amoxicillin component.
<12wks: 30mg/kg/day in 2 divided doses every 12hrs (use 125mg/5mL).
≥12wks (<40kg): Twice-daily regimen: use 200mg or 400mg. Three times daily regimen: use 125mg or 250mg. 45mg/kg/day in 2 divided doses every 12hrs or 40mg/kg/day in 3 divided doses every 8hrs.
≥40kg: 500mg every 12hrs or 250mg every 8hrs
Augmen
tin
1
125mg/31.25mg per 5mL susp banana
250mg/62.5mg per 5mL susp orange
600mg/42.9mg per 5mL ES-600 susp strawberry cream <3mos: Not recommended.
≥3mos (<40kg): 90mg/kg/day in 2 divided doses every 12hrs
≥40kg: Not recommended (use adult forms)
azithromycin Zithromax 100mg/5mL,
200mg/5mL
susp cherry-vanilla-banana <6mos: Not established.
≥6mos: 30mg/kg as a single dose (max 1.5g); or 10mg/kg (max 500mg) once daily for 3 days; or 10mg/kg (max 500mg) once then 5mg/kg (max 250mg) per day for 4 days.
cefaclor 125mg/5mL, 250mg/5mL, 375mg/5mL susp strawberry <1mo: Not recommended.
≥1mo: 40mg/kg/day in 2 divided doses every 12hrs, or in 3 divided doses every 8hrs; max 1g/day
cefdinir 125mg/5mL, 250mg/5mL susp strawberry <6mos: Not recommended. >6mos: 14mg/kg every 24hrs for 10 days or 7mg/kg every 12hrs for 5−10 days; max 600mg/day
cefixime Suprax 100mg/5mL,
200mg/5mL
susp strawberry <6mos: Not established.
6mos−12yrs (<50kg): 8mg/kg once daily or 4mg/kg every 12hrs
>12yrs or >50kg: 400mg once daily or 200mg every 12hrs
cefpodoxime 50mg/5mL, 100mg/5mL susp lemon-creme <2mos: Not recommended.
≥2mos: 5mg/kg (max 200mg) every 12hrs for 5 days
cefprozil 125mg/5mL, 250mg/5mL susp bubble gum <6mos: Not recommended.
>6mos: 30mg/kg/day in 2 divided doses every 12hrs
ceftriaxone 500mg/vial,
1g/vial
inj 50mg/kg IM once; max 1g
cefuroxime 250mg, 500mg tabs <13yrs (able to swallow tab whole): 250mg twice daily for 10 days
cephalexin Keflex 250mg, 500mg, 750mg caps 75−100mg/kg/day in equally divided doses
ciprofloxacin Otiprio2 6% otic susp <6mos: Not established.
>6mos: one 0.1mL (6mg) single dose into each affected ear, after effusion suctioning
clarithro
mycin
125mg/5mL, 250mg/5mL susp fruit-punch <6mos: Not established.
>6mos: 7.5mg/kg every 12hrs for 10 days
sulfameth
oxazole/
trimethoprim
200mg/40mg per 5mL susp cherry, grape <2mos: Not recommended.
≥2mos: 8mg/kg of TMP (40mg/kg of SMX) per day in 2 divided doses every 12hrs for 10 days
NOTES

Key: drops = oral drops; SMX = sulfamethoxazole; susp = oral suspension (as supplied or after reconstitution); TMP = trimethoprim

1 These products should be taken with food.

2 For intratympanic administration only, in patients with effusion undergoing tympanostomy tube placement.

Not an inclusive list of medications, dosing regimens, formulations, and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. Information on prophylaxis of chronic otitis media infections is not included. Under certain clinical conditions (eg, impaired renal or hepatic function), the dose may need to be adjusted. Unless stated otherwise, otitis media is generally treated for 10−14 days.

(Rev. 5/2021)