QuestionSBA
QuestionChoice
For people who are allergic to, or intolerant of, penicillin, it would be appropriate to prescribe a five to seven-day course of clarithromycin.
10005432
b
Oral Clarithromycin
QuestionChoice
This is a self-care measure for symptom relief and prevention of recurrent infection in otitis externa.
10005435
e
Acetic acid 2% ear drops
QuestionChoice
Regular doses of paracetamol or ibuprofen are advised for pain but provided this patient is systemically unwell, antibiotics are most appropriate to prevent progression to sepsis.
10005433
c
Simple analgesia
QuestionChoice
The most likely diagnosis here is otitis media. NICE guidance states that for people who do not require admission to hospital but are systemically very unwell as in this case, offer an immediate antibiotic prescription and if an antibiotic is required, prescribe a five to seven-day course of amoxicillin.
10005431
a
Oral amoxicillin
QuestionChoice
This is not advised when there is tympanic perforation.
10005434
d
Ear irrigation
Concept
Chapter
2693
4405
Otitis Media
Topic
186
Ear, Nose and Throat
13633
A four-year-old boy is taken to the emergency department by his mother with a 72-hour history of left ear pain. His mother reports that his left ear started to leak some purulent material this morning. He has no significant past medical history and no allergies. On examination, the external ear did not appear erythematous and the discharge was not obvious from external inspection. He had a pulse rate of 130bpm and a temperature of 38.5 degrees. Otoscopy revealed a red tympanic membrane with a perforation and white purulent discharge in the external auditory canal.

Which of the following is the most appropriate management of this patient?
a