What is the first-line treatment for acute otitis media?

Amoxicillin is considered the first-line treatment for acute otitis media (AOM) due to its effectiveness against the most common bacterial pathogens responsible for this condition, including Streptococcus pneumoniae and Haemophilus influenzae. The majority of AOM cases are viral, but when bacterial infection is suspected, amoxicillin is recommended because it has a good safety profile, is generally well-tolerated by children, and is cost-effective.

In cases where the patient presents with moderate to severe symptoms or if the child has been previously treated with amoxicillin within the past 30 days, a broader spectrum antibiotic like Augmentin may be utilized as a second-line treatment. However, for uncomplicated AOM in otherwise healthy children, amoxicillin remains the preferred choice initially.

Ceftriaxone and azithromycin are typically reserved for situations where there is a penicillin allergy or treatment failure with first-line agents, making them less suitable as a first-line option for AOM. Thus, amoxicillin is the most appropriate initial therapy for this common pediatric condition.