Kligman E W
University of Arizona College of Medicine, Tucson.
Am Fam Physician. 1992 Jan;45(1):242-50.
Amoxicillin is the first-line drug for otitis media. Effective second-line drugs for resistant beta-lactamase-producing bacterial strains include trimethoprim-sulfamethoxazole, erythromycin-sulfisoxazole, cefaclor, cefuroxime axetil and cefixime. In choosing an antibiotic, the physician should consider proven efficacy, cost, side effect profile, compliance issues, spectrum of coverage and the age of the child. Children with recurrent infections may benefit from antibiotic prophylaxis. About 10 percent of children with episodes of acute otitis media develop a chronic middle ear effusion that persists beyond three months. Referral for insertion of tympanostomy tubes is most appropriate for patients with documented language delay and/or significant medical complications.
阿莫西林是中耳炎的一线用药。对于产生耐药性的β-内酰胺酶细菌菌株，有效的二线药物包括复方磺胺甲恶唑、琥乙红霉素、头孢克洛、头孢呋辛酯和头孢克肟。在选择抗生素时，医生应考虑已证实的疗效、成本、副作用、依从性问题、覆盖范围以及儿童年龄。反复感染的儿童可能会从抗生素预防中获益。约10%患急性中耳炎的儿童会出现持续超过三个月的慢性中耳积液。对于有语言发育迟缓记录和/或严重医疗并发症的患者，转诊进行鼓膜造孔管插入术最为合适。
