Caused by enterotoxigenic Clostridium difficille. Treat with Vancomycin. Indications for Antimicrobial Treatment A. Otitis Media 1. Keflex middle ear levels felt to be inadequate for most pathogens. Ceclor good middle ear levels observed.
Clavulanic acid reaches levels sufficient to inhibit beta- lactamase.
Most recommend 7-10 days of treatment 2. Recurrent Otitis Media - Children experiencing three or more episodes in a 6 month period. Otitis Media with Effusion - Special considerations given because of possible cause of developmental delay. Malignant External Otitis - Seen in elderly diabetics with persistent external otitis who develop severe pain, persistant discharge, swelling, tenderness, and external canal granulation tissue is seen. Pneumococcus, non-typable H. influenzae, and less commonly, oral anaerobes.