| Antimicrobials* |
| Amoxicillin | 80 to 90 mg per kg per day, given orally in two divided doses | First-line drug. Safe, effective, and inexpensive |
| Amoxicillin/clavulanate (Augmentin) | 90 mg of amoxicillin per kg per day; 6.4 mg of clavulanate per kg per day, given orally in two divided doses | Second-line drug. For patients with recurrent or persistent acute otitis media, those taking prophylactic amoxicillin, those who have used antibiotics within the previous month, and those with concurrent purulent conjunctivitis |
| Azithromycin (one dose; Zithromax) | 30 mg per kg, given orally | For patients with penicillin allergy. One dose is as effective as longer courses |
| Azithromycin (three-day course; Zithromax Tri-pak) | 20 mg per kg once daily, given orally | For patients with recurrent acute otitis media |
| Azithromycin (five-day course; Zithromax Z-pak) | 5 to 10 mg per kg once daily, given orally | For patients with penicillin allergy (type 1 hypersensitivity) |
| Cefdinir (Omnicef) | 14 mg per kg per day, given orally in one or two doses | For patients with penicillin allergy, excluding those with urticaria or anaphylaxis to penicillin (i.e., type 1 hypersensitivity) |
| Cefpodoxime (Vantin) | 30 mg per kg once daily, given orally | For patients with penicillin allergy, excluding those with urticaria or anaphylaxis to penicillin (i.e., type 1 hypersensitivity) |
| Ceftriaxone (Rocephin) | 50 mg per kg once daily, given intramuscularly or intravenously. One dose for initial episode of otitis media, three doses for recurrent infections | For patients with penicillin allergy, persistent or recurrent acute otitis media, or vomiting |
| Cefuroxime (Ceftin) | 30 mg per kg per day, given orally in two divided doses | For patients with penicillin allergy, excluding those with urticaria or anaphylaxis to penicillin (i.e., type 1 hypersensitivity) |
| Clarithromycin (Biaxin) | 15 mg per kg per day, given orally in three divided doses | For patients with penicillin allergy (type 1 hypersensitivity). May cause gastrointestinal irritation |
| Clindamycin (Cleocin) | 30 to 40 mg per kg per day, given orally in four divided doses | For patients with penicillin allergy (type 1 hypersensitivity) |
| Topical agents† |
| Ciprofloxacin/hydrocortisone (Cipro HC Otic) | 3 drops twice daily | — |
| Hydrocortisone/neomycin/polymyxin B (Cortisporin Otic) | 4 drops three to four times daily | — |
| Ofloxacin (Floxin Otic) | 5 drops twice daily (10 drops in patients older than 12 years) | — |
| Analgesics |
| Acetaminophen | 15 mg per kg every six hours | — |
| Antipyrine/benzocaine (Auralgan) | 2 to 4 drops three to four times daily | — |
| Ibuprofen (Motrin) | 10 mg per kg every six hours | — |
| Narcotic agents | Variable | May cause gastrointestinal upset, respiratory depression, altered mental status, and constipation |