EARS - Mastoiditis, Simple (Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae) Comment: Empirical treatment same as acute otitis media. May need to adjust therapy if cultures show S. aureus or gram-negative enteric bacilli.
Amoxicillin/clavulanate (Augmentin^®) Pregnancy: B; Lactation: Unk Q12H Formulations: Tabs: 500 mg/125 mg, 875 mg/125 mg Chewable Tabs: 400 mg/57 mg Oral Susp: 400 mg/57 mg/5 mL, 600 mg/42.9 mg/5 mL	Children: 80-90 mg amoxicillin component/kg/day (max 1600 mg/day) in divided doses two or three times daily. If <2 years × 10 days. If ≥2 years 5-7 days. Q12H using 400 mg/5 mL susp @ 90 mg/kg/day 10 kg (22 lb) = 1 tsp (5 mL) Q12H 15 kg (33 lb) = 1½ tsp (7.5 mL) Q12H 20 kg (44 lb) = 2 tsp (10 mL) Q12H >20 kg = Use adult dose. Q12H using 600 mg/5 mL susp @ 90 mg/kg/day 8 kg (18 lb) = 3 mL Q12H 12 kg (26 lb) = 4.5 mL Q12H 16 kg (35 lb) = 6 mL Q12H 20 kg (44 lb) = 7.5 mL Q12H 24 kg (53 lb) = 9.0 mL Q12H 28 kg (62 lb) = 10.5 mL Q12H 32 kg (70 lb) = 12.0 mL Q12H 36 kg (79 lb) = 13.5 mL Q12H >40 kg = Experience not available. Adult: 500-875 mg twice daily for 10 days. Note: Q12H dosing may improve compliance compared to Q8H dosing.	Food: Take with food to reduce diarrhea. Important side effects: Diarrhea (common), nausea, rash. May cause nonallergic maculopapular rash.
Cefuroxime axetil (Ceftin^®) Pregnancy: B; Lactation: Unsafe Tabs: 125 mg, 250 mg, 500 mg Oral Suspension: 125 mg/5 mL, 250 mg/5 mL	Children >3 months to 12 years: 30 mg/kg/day (NTE 1,000 mg/day) in divided doses twice daily 10 days. 125 mg/5 mL @ 30 mg/kg/day 8 kg (18 lb) = 1 tsp (5 mL) Q12H 12.5 kg (27 lb) = 1½ tsp (7.5 mL) Q12H 17 kg (37 lb) = 2 tsp (10 mL) Q12H 25 kg (55 lb) = 3 tsp (15 mL) Q12H 33 kg (73 lb) = Use adult dose. Adult: 250-500 mg PO twice daily for 10 days.	Food: Take suspension with food, tablets without regard to food.
EARS - Mastoiditis, Malignant (Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae) Comment: Requires parenteral antimicrobial therapy. If hospitalization is delayed, initiate empiric therapy with ceftriaxone IM, an oral fluoroquinolone, or other therapy appropriate for acute otitis media.