Running head: OTITIS MEDIA CASE STUDY 1
Otitis Media Case Study
Sally Chambless
The University of Texas at Arlington
College of Nursing and Health Innovation
In partial fulfillment of the requirements of
Advanced Pharmacology (NURS 5334)
Mary Davis, DNP, MSN, ANP-BC, ADM-BC
,OTITIS MEDIA CASE STUDY 2
5334 CASE SUMMARY TABLE
• Symptoms: List two pertinent signs and symptoms or risk factors
• Fever of 39.5֯ C for greater than 24 hours (Burcham & Rosenthal, 2019, p.
1306).
• Erythematous right tympanic membrane (TM), bulging TM with limited
mobility, and purulent fluid behind TM (Burcham & Rosenthal, 2019, p. 1304).
• Recommended Drugs:
List three recommended drugs (list one of each: Antibiotic, pain med and med for
fever) as indicated for this diagnosis
• Antibiotic: Amoxicillin-clavulanate (Burcham & Rosenthal, 2019, p. 1306).
• Ibuprofen: Pain reducer (Burcham & Rosenthal, 2019, p. 1307).
• Acetaminophen: Fever reducer (Burcham & Rosenthal, 2019, p. 1306).
• Drug Categories and Subcategories:
Identify the category of each recommended drug
1. Amoxicillin-clavulanate
➢ Category: Anti-infective (Lexicomp, 2017, p. 127)
➢ Subcategory: Aminopenicillins (Lexicomp, 2017, p. 127)
2. Ibuprofen
➢ Category: Nonopioid analgesic (Lexicomp, 2017, p. 1132)
➢ Subcategory: Nonsteroidal Anti-inflammatory Drug (NSAID) (Lexicomp, 2017,
p. 1132)
3. Acetaminophen
➢ Category: Antipyretic (Lexicomp, 2017, p. 50)
➢ Subcategory: Analgesic (Lexicomp, 2017, p. 50)
• Choose antibiotic from the above three recommended drugs to treat identified
disease
• Amoxicillin-clavulanate (Augmentin)
• Rationale
Provide rationale, clinical guidelines, or evidence for the antibiotic selected as drug of
choice
, OTITIS MEDIA CASE STUDY 3
The patient should be treated with amoxicillin-clavulanate based upon the history of
chronic otitis media infections and current severe otitis media (AOM) infection. Patient has
had three previous AOM infections with the most recent infection only two weeks prior
treated with high dose amoxicillin. The recurrent AOM infections in conjunction with the
recent upper respiratory infection, indicates the patient exposure, and likely infection, with
M. catarrhalis or S. pneumoniae, which can be resistant to amoxicillin, or H. influenzae,
which produces beta-lactamase and inactivates amoxicillin (Burcham & Rosenthal, 2019, p.
1307). Therefore, the preferred treatment would be amoxicillin-clavulanate because the
clavulanic acid will impede beta-lactamase (Burcham & Rosenthal, 2019, p. 1307). The
present clinical guidelines indicate treatment with amoxicillin-clavulanate if a patient has
been treated with amoxicillin for AOM within the past 30 days and presents with severe
subsequent illness (Lexicomp, 2017, p. 129).
• Contraindications and or Risks, as appropriate:
Identify contraindications and risks as appropriate
1. Amoxicillin-clavulanate: Contraindications: penicillin allergy, hepatic impairment,
renal impairment (Lexicomp, 2017, p. 130). Risks: administer with food to prevent
nausea, test for c-diff if diarrhea develops (Lexicomp, 2017, p. 130).
2. Ibuprofen: Contraindications: allergy to NSAIDs or salicylates, cardiac risk, or GI
bleed (Lexicomp, 2017, p. 1134). Risks: include weight gain, edema, bruising,
bleeding, abdominal pain, dyspepsia, mental confusion, disorientation, hypertension,
infection, and headache (Lexicomp, 2017, p. 1134).
Otitis Media Case Study
Sally Chambless
The University of Texas at Arlington
College of Nursing and Health Innovation
In partial fulfillment of the requirements of
Advanced Pharmacology (NURS 5334)
Mary Davis, DNP, MSN, ANP-BC, ADM-BC
,OTITIS MEDIA CASE STUDY 2
5334 CASE SUMMARY TABLE
• Symptoms: List two pertinent signs and symptoms or risk factors
• Fever of 39.5֯ C for greater than 24 hours (Burcham & Rosenthal, 2019, p.
1306).
• Erythematous right tympanic membrane (TM), bulging TM with limited
mobility, and purulent fluid behind TM (Burcham & Rosenthal, 2019, p. 1304).
• Recommended Drugs:
List three recommended drugs (list one of each: Antibiotic, pain med and med for
fever) as indicated for this diagnosis
• Antibiotic: Amoxicillin-clavulanate (Burcham & Rosenthal, 2019, p. 1306).
• Ibuprofen: Pain reducer (Burcham & Rosenthal, 2019, p. 1307).
• Acetaminophen: Fever reducer (Burcham & Rosenthal, 2019, p. 1306).
• Drug Categories and Subcategories:
Identify the category of each recommended drug
1. Amoxicillin-clavulanate
➢ Category: Anti-infective (Lexicomp, 2017, p. 127)
➢ Subcategory: Aminopenicillins (Lexicomp, 2017, p. 127)
2. Ibuprofen
➢ Category: Nonopioid analgesic (Lexicomp, 2017, p. 1132)
➢ Subcategory: Nonsteroidal Anti-inflammatory Drug (NSAID) (Lexicomp, 2017,
p. 1132)
3. Acetaminophen
➢ Category: Antipyretic (Lexicomp, 2017, p. 50)
➢ Subcategory: Analgesic (Lexicomp, 2017, p. 50)
• Choose antibiotic from the above three recommended drugs to treat identified
disease
• Amoxicillin-clavulanate (Augmentin)
• Rationale
Provide rationale, clinical guidelines, or evidence for the antibiotic selected as drug of
choice
, OTITIS MEDIA CASE STUDY 3
The patient should be treated with amoxicillin-clavulanate based upon the history of
chronic otitis media infections and current severe otitis media (AOM) infection. Patient has
had three previous AOM infections with the most recent infection only two weeks prior
treated with high dose amoxicillin. The recurrent AOM infections in conjunction with the
recent upper respiratory infection, indicates the patient exposure, and likely infection, with
M. catarrhalis or S. pneumoniae, which can be resistant to amoxicillin, or H. influenzae,
which produces beta-lactamase and inactivates amoxicillin (Burcham & Rosenthal, 2019, p.
1307). Therefore, the preferred treatment would be amoxicillin-clavulanate because the
clavulanic acid will impede beta-lactamase (Burcham & Rosenthal, 2019, p. 1307). The
present clinical guidelines indicate treatment with amoxicillin-clavulanate if a patient has
been treated with amoxicillin for AOM within the past 30 days and presents with severe
subsequent illness (Lexicomp, 2017, p. 129).
• Contraindications and or Risks, as appropriate:
Identify contraindications and risks as appropriate
1. Amoxicillin-clavulanate: Contraindications: penicillin allergy, hepatic impairment,
renal impairment (Lexicomp, 2017, p. 130). Risks: administer with food to prevent
nausea, test for c-diff if diarrhea develops (Lexicomp, 2017, p. 130).
2. Ibuprofen: Contraindications: allergy to NSAIDs or salicylates, cardiac risk, or GI
bleed (Lexicomp, 2017, p. 1134). Risks: include weight gain, edema, bruising,
bleeding, abdominal pain, dyspepsia, mental confusion, disorientation, hypertension,
infection, and headache (Lexicomp, 2017, p. 1134).
