What class of antibiotics is commonly prescribed for acute otitis media?

High dose amoxicillin is the first-line treatment for acute otitis media due to its effectiveness against the most common pathogens responsible for this infection, particularly Streptococcus pneumoniae and Haemophilus influenzae. This choice is based on clinical guidelines that emphasize amoxicillin’s efficacy and safety profile in children and adults.

In the case of acute otitis media, the goal is to provide adequate coverage for these organisms while also considering the possibility of antibiotic resistance. High dose amoxicillin—typically prescribed at 80-90 mg/kg/day—has been shown to overcome resistance mechanisms associated with Streptococcus pneumoniae due to its improved pharmacokinetics when dosed at this higher level.

While other classes of antibiotics, such as macrolides and cephalosporins, may be utilized in cases of penicillin allergy or in specific situations where resistance patterns warrant their use, they are not first-line therapies for uncomplicated acute otitis media. Fluoroquinolones, although effective for certain types of infections, are generally not used for this condition due to concerns regarding resistance and side effects, as well as their broader spectrum of activity, which is unnecessary for typical cases of acute otitis media.

Thus, the recommendation for