Otitis media
The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.
Treatment of acute otitis media
Analgesia, no antibiotic treatment (majority resolve in 24 hrs). Both viral and bacterial infections causing acute otitis media are usually self-limiting and do not routinely require antibiotics.
Amoxicillin
Amoxicillin 500mg capsules
500mg every 8 hours for 5 days.
If penicillin allergic, prescribe doxycycline.
Doxycycline
Doxycycline 100mg capsules
200mg on day 1, then 100mg daily for 5 days treatment in total.
For penicillin allergy in pregnancy.
Erythromycin
Erythromycin 250mg gastro-resistant tablets
500mg every 6 hours for 5 days.
Prescribing Notes:
- Antibiotics do not reduce pain in the first 24 hours and make no difference to the likelihood of a further infection or hearing difficulty.
- Consider antibiotics if any of the following are present: systemic toxicity, otorrhoea, recurrent ear infection, immunocompromised, debilitated or prolonged illness (more than 2-3 days). In other cases, consider withholding prescription or give delayed prescription.
History Notes
30/07/2026
Regional formulary chapter launched.