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Episode 62 Pharyngitis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Childhood Memories by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 61 Otitis Media

Question 1 — Initial management (observation vs antibiotics)

A 28‑month‑old boy is brought in for 1 day of ear pain and fussiness. His temperature in clinic is 38.3 °C (100.9 °F). He is otherwise healthy, immunizations are up to date, and there has been no antibiotic use in the past month. Otoscopy shows a mildly bulging, erythematous tympanic membrane on the right with preserved landmarks; the left ear is normal. He is drinking adequately and has mild, controllable pain. What is the most appropriate next step in management?

B. Watchful waiting for 48–72 hours with scheduled oral analgesics and clear return precautions

Question 2 — First‑line antibiotic and dosing

A 3‑year‑old girl presents with 2 days of bilateral ear pain and poor sleep. She is well‑appearing, has no conjunctivitis, and has not taken antibiotics in the last 30 days. Otoscopy reveals moderate bulging of both tympanic membranes with middle‑ear effusions. What is the most appropriate initial antibiotic regimen?

D. Amoxicillin 80–90 mg/kg/day PO divided twice daily

Question 3 — Duration of therapy

A 6‑year‑old boy with non‑severe unilateral AOM is started on high‑dose amoxicillin. He has no tympanic membrane perforation, and symptoms are improving after 48 hours. What is the most appropriate total duration of antibiotic therapy for this patient?

C. 5–7 days

Paper for Next Week:

Podwojniak, A., Tan, I. J., Sauer, J., Neubauer, Z., Rothenberg, H., Ghani, H., Parikh, A. K., & Cohen, B. (2025). Acne and the cutaneous microbiome: A systematic review of mechanisms and implications for treatments. Journal of the European Academy of Dermatology and Venereology, 39, 793–805.

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