For acute otitis media in a patient who has had antibiotic therapy within the past 30 days, which antibiotic is preferred?

For acute otitis media in a patient who has had antibiotic therapy within the past 30 days, which antibiotic is preferred?

• A. Amoxicillin
• B. Amoxicillin/clavulanate
• C. Azithromycin
• D. Cefdinir

Answer: (B)

When deciding how to treat acute otitis media, recent antibiotic use increases the likelihood of infection with resistant bacteria, especially beta-lactamase–producing strains of common pathogens. Amoxicillin alone may fail against those organisms. Adding clavulanate inhibits beta-lactamase, broadening the antibiotic’s activity to include beta-lactamase–producing Haemophilus influenzae and Moraxella catarrhalis, making it more reliable after recent antibiotics. That broader coverage is why amoxicillin-clavulanate is preferred in this scenario. The other options lack this necessary enzyme inhibition or have lower efficacy in this setting, making them less suitable choices here.

When deciding how to treat acute otitis media, recent antibiotic use increases the likelihood of infection with resistant bacteria, especially beta-lactamase–producing strains of common pathogens. Amoxicillin alone may fail against those organisms. Adding clavulanate inhibits beta-lactamase, broadening the antibiotic’s activity to include beta-lactamase–producing Haemophilus influenzae and Moraxella catarrhalis, making it more reliable after recent antibiotics. That broader coverage is why amoxicillin-clavulanate is preferred in this scenario. The other options lack this necessary enzyme inhibition or have lower efficacy in this setting, making them less suitable choices here.