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Penatalaksanaan Otitis Media Akut

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Penatalaksanaan Otitis Media
Akut
Antibiotik
•
•
•
•
Diberikan minimal 10 hari sampai MT terlihat normal
First line : amoxicilin
Alergi: eritromicin atau kotrimoxazole
β-lactamase-producing H. influenzae atau M. catarrhalis: amoxicillin
clavulanate, augmentin, cefuroxime axetil or cefixime
Dhingra 6th
Decongestant nasal drop
• Ephedrine nose drops (1% in adults and 0.5%
in children) or
• Oxymetazoline (Nasivion) or xylometazoline
(Otrivin) should be used to relieve eustachian
tube oedema and promote ventilation of
middle ear.
Dhingra 6th
Oral decongestant
• Pseudoephedrine 30 mg twice daily or
• a combination of decongestant and
antihistaminic may achieve the same result
without resort to nasal drops which are
difficult to administer in children.
Dhingra 6th
Analgesics and antipyretics.
Paracetamol helps to relieve
pain and bring down
temperature.
Ear toilet.
If there is discharge in the ear, it is drymopped with sterile cotton buds and a wick
moistened with antibiotic may be inserted
Dhingra 6th
Miringotomi / Timpanosintesis
incising the drum to evacuate pus
indicated when:
1. drum is bulging and there is acute pain,
2. there is an incomplete resolution despite
antibiotics when drum remains full with
persistent conductive deafness
3. there is persistent effusion beyond 12 weeks.
4. allows samples to be obtained for culture
Dhingra 6th and Bailey 5th
Myringotomy with Tympanostomy
Tube Insertion
• promotion of ventilation of the middle ear
• drainage through both the eustachian tube
and the tympanostomy tube
• When medical treatments for recurrent AOM
have failed, tympanostomy tube insertion is
recommended.
• Medical treatments failed usually defined as
three or more episodes in 6 months or four or
more episodes in 12 months
Bailey 5th
Dhingra 6th
Tamir, Sharon & Shemesh, Shay & Oron, Yahav & Marom, Tal. (2017). Acute Otitis Media Guidelines in Selected Developed and
Developing Countries: Uniformity and Diversity. Archives of Disease in Childhood. 102. 450-457. 10.1136/archdischild-2016-310729.
Tamir, Sharon & Shemesh, Shay & Oron, Yahav & Marom, Tal. (2017). Acute Otitis Media Guidelines in Selected Developed and
Developing Countries: Uniformity and Diversity. Archives of Disease in Childhood. 102. 450-457. 10.1136/archdischild-2016-310729.
Tamir, Sharon & Shemesh, Shay & Oron, Yahav & Marom, Tal. (2017). Acute Otitis Media Guidelines in Selected Developed and
Developing Countries: Uniformity and Diversity. Archives of Disease in Childhood. 102. 450-457. 10.1136/archdischild-2016-310729.
Tamir, Sharon & Shemesh, Shay & Oron, Yahav & Marom, Tal. (2017). Acute Otitis Media Guidelines in Selected Developed and
Developing Countries: Uniformity and Diversity. Archives of Disease in Childhood. 102. 450-457. 10.1136/archdischild-2016-310729.
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