Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
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Ear problems<br />
590<br />
• If allergic to penicillin and has perforation for less than 6 weeks treat with<br />
roxithromycin<br />
Schedule 4 Roxithromycin<br />
DTP<br />
IHW / SM R&IP / IPAP<br />
Authorised Indigenous <strong>Health</strong> Workers and Isolated Practice Area Paramedic must consult MO / NP<br />
Scheduled Medicines Rural & Isolated Practice Registered Nurses may proceed<br />
Form Strength<br />
Route of<br />
administration<br />
Recommended<br />
dosage<br />
Duration<br />
Tablet<br />
150 mg<br />
300 mg<br />
Adult<br />
300 mg daily<br />
Tablet for<br />
suspension<br />
50 mg<br />
Oral<br />
Child<br />
4 mg / kg / dose bd<br />
to a max. of 150 mg bd<br />
10 days<br />
Provide Consumer Medicine Information: should be taken on an empty stomach, 15 minutes before food.<br />
Ensure course is completed<br />
Management of associated emergency: consult MO<br />
[5]<br />
• If discharge present for longer than 14 days MO may add ciprofloxacin drops<br />
Schedule 4<br />
Ciprofloxacin hydrochloride<br />
ear drops<br />
DTP<br />
IHW<br />
Ciprofloxacin hydrochloride ear drops must be ordered by MO / NP. MO / NP note restrictions<br />
Authorised Indigenous <strong>Health</strong> Workers can only administer on MO / NP order<br />
Form Strength<br />
Route of<br />
administration<br />
Recommended<br />
dosage<br />
Duration<br />
Ear drops<br />
Ear drops<br />
(0.3%)<br />
Topical<br />
Instil 5 drops in<br />
affected ear bd<br />
Until the ear is dry<br />
or 9 days<br />
Provide Consumer Medicine Information: if not drying in 2 weeks check with family on ability to clean and<br />
instil drops<br />
Management of associated emergency: as for severe allergic reactions. See Anaphylaxis<br />
Administration tip<br />
-- The patient should be sitting or lying down with the affected ear upwards<br />
-- Once the drops have been instilled maintain position for 30 - 60 sec.<br />
-- Apply tragal pressure (pressing several times on the flap of skin in front of ear canal) after the drops<br />
have been instilled to assist the drops through the perforation<br />
[8]<br />
5. Follow up<br />
Review the patient in 2 days<br />
If not improving consult MO<br />
Weekly review until the signs of AOM with perforation have resolved<br />
If failing to resolve discuss with parents / carer - explore if the child is being<br />
given antibiotics. Is the child spitting it out or vomiting afterwards? Consider daily<br />
treatment in the clinic or use IM procaine penicillin<br />
If the discharge continues after 6 weeks of treatment manage See Chronic<br />
suppurative otitis media (CSOM)<br />
If perforation heals review in 6 weeks:<br />
- - inspect ear drum<br />
-- perform hearing assessment - audiometry and tympanometry<br />
- - advise to prevent recurrent otitis media with good personal hygiene in children<br />
- - Breathe, blow, cough (BBC) program is targeted at school aged children<br />
Controlled copy V1.0<br />
Primary Clinical Care Manual 2011
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