ear infection case study and treatment options

You are a doctor and your patient is a small boy, 6 years old. He has an ear infection: the ear is red and inflamed and the boy is fussy (seems to be feverish). You do not definitively know the causative agent of the infection (it could be Streptococcus pyogenes, Haemophilus influenzae, or a number of other possible pathogens). You have 3 treatment options. Give the pros and cons for each option and decide which you would choose (or come up with your own or decide on a combination). Your decision (and pros/cons) should consider what is best for the child AND what is best for the entire population.

  1. You prescribe the latest 4th generation cephalosporin to treat the infection, a wide-spectrum drug which has a 100% chance of getting rid of the infection.
  2. You prescribe Augmentin, which is a penicillin drug (amoxicillin) plus clavulanic acid to counteract possible beta-lactamases (penicillinases); this is also a broad-spectrum drug (side effects would be the same as drug in #1) but is much more common. It has a 70-80% chance of taking care of the infection.
  3. You culture the pathogen from the ear to determine the causative agent and also screen it for antibiotic resistances before you prescribe an antibiotic.

Note: assume the drug in #1 and the drug in #2 have the same side effects (they are similar broad-spectrum drugs) so different side effects or “strength” of the drug isn’t a problem