{ "schema_version": 1, "kind": "condition", "id": "acute-otitis-media", "name": "Acute otitis media", "category": "infectious", "sources": "WHO EML 2023 · Egyptian National Drug Formulary - Antimicrobial 2023 (azithromycin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (cefdinir monograph) · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Matz O, Sutton AE, Ashurst JV. Acute Otitis Media. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: June 8, 2026. · Egyptian National Drug Formulary - Antimicrobial 2023 (ceftriaxone monograph)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (azithromycin monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (cefdinir monograph) · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Matz O, Sutton AE, Ashurst JV. Acute Otitis Media. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: June 8, 2026.", "verified_date": "2026-08", "treatments": [ { "id": 69, "generic": "Amoxicillin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg TID", "adult_duration": "5-7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin monograph)", "rationale": "High-dose amoxicillin (80-90 mg/kg/day) where pneumococcal resistance is likely.", "cautions": [ "Avoid in penicillin allergy.", "Reduce dose in severe renal impairment.", "A rash occurs if amoxicillin is given in glandular fever." ], "peds_mgkg_low": 40.0, "peds_mgkg_high": 90.0, "peds_max_mg": 1000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Divided BID-TID; high dose (80-90) where pneumococcal resistance is likely ENDF caps amoxicillin at 500 mg per dose for most indications; at the twice-daily schedule this regimen uses, that is 1,000 mg in a day, which is the ceiling applied to the table above (ENDF Antimicrobial 2023).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 400, "high_mg": 900, "capped": false }, { "weight_kg": 20, "low_mg": 800, "high_mg": 1000, "capped": true }, { "weight_kg": 30, "low_mg": 1000, "high_mg": 1000, "capped": true }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 1000, "capped": true } ], "brands": [ { "trade_name": "AMOXYCILLIN 500MG 10 CAPS B.P.2013", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 6.5, "pack_count": 10, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMOXICILLIN 500MG 12 CAPS. USP 28", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA", "price_egp": 8.1, "pack_count": 12, "unit_price": 0.67, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMOXIL 500MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > SMITHKLINE BEECHAM", "price_egp": 9.0, "pack_count": 12, "unit_price": 0.75, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMOXICID 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 9.5, "pack_count": 12, "unit_price": 0.79, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "E-MOX 500 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 15.6, "pack_count": 16, "unit_price": 0.97, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HICONCIL 500MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 11.6, "pack_count": 12, "unit_price": 0.97, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIOMOX 500MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 19.5, "pack_count": 12, "unit_price": 1.62, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBIAMOX 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 45.0, "pack_count": 12, "unit_price": 3.75, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HICILLIN 125MG/5ML SUSP. 80ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 3.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "AMOXIL FORT 250MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > SMITHKLINE BEECHAM", "price_egp": 5.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" }, { "id": 70, "generic": "Amoxicillin + Clavulanic acid", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 1000.0, "adult_dose": "875 mg twice daily or 500 mg every 8 hours", "adult_duration": "5-7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)", "rationale": "High-dose 80-90 mg/kg/day is standard for AOM where pneumococcal resistance is likely. It requires a 14:1 ES product, which is sold in Egypt; a 7:1 product at this dose would deliver toxic clavulanate.", "cautions": [ "Avoid in penicillin allergy.", "Diarrhoea is more common than with amoxicillin alone.", "Cholestatic jaundice can occur, and this combination is avoided if there has been a previous reaction." ], "peds_mgkg_low": 80.0, "peds_mgkg_high": 90.0, "peds_max_mg": 4000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Of the amoxicillin component, divided BID. Use a 14:1 ES formulation (AUGMENTIN ES-600 or a 642.9 mg/5 mL suspension) so clavulanate stays under 10 mg/kg/day at this dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 800, "high_mg": 900, "capped": false }, { "weight_kg": 20, "low_mg": 1600, "high_mg": 1800, "capped": false }, { "weight_kg": 30, "low_mg": 2400, "high_mg": 2700, "capped": false }, { "weight_kg": 40, "low_mg": 3200, "high_mg": 3600, "capped": false } ], "brands": [ { "trade_name": "E-MOXCLAV 1G 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 14.0, "pack_count": 10, "unit_price": 1.4, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "JULMENTIN 2X 1GM 15 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 57.5, "pack_count": 15, "unit_price": 3.83, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEXICLAVE 1 GM 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > NOVELL PHARMA", "price_egp": 38.5, "pack_count": 10, "unit_price": 3.85, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MACLAVEX 1 GM 14 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 105.0, "pack_count": 14, "unit_price": 7.5, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLAVIMOX 1 GM 12 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 130.0, "pack_count": 12, "unit_price": 10.83, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEGAMOX 1 GM 14 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL JAZEERA PHARMACEUTICAL > HIKMA PHARMA", "price_egp": 178.0, "pack_count": 14, "unit_price": 12.71, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLAVOCILLIN 1 GM 10 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ORGANOPHARMA", "price_egp": 106.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGMENTIN ADULTS 1GM/125MG 12 PWD. ORAL SUSP. SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 169.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 156.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" }, { "id": 71, "generic": "Cefdinir", "line": 3, "is_adjunct": false, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "Total daily dose 600 mg - as 300 mg twice daily or 600 mg once daily", "adult_duration": "10 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (cefdinir monograph)", "rationale": "32 live products, mostly paediatric suspension, and the formulary lists acute bacterial otitis media in children as a named indication. Once-daily dosing and better palatability than amoxicillin-clavulanate make it the practical option when a child will not take the first-line suspension.", "cautions": [ "A third-generation oral cephalosporin in the formulary's WATCH group - it must not displace amoxicillin as first-line, which drives pneumococcal resistance.", "Iron preparations and antacids block absorption - separate by 2 hours; iron also turns the stools reddish, which is harmless but alarms parents.", "Once-daily dosing has not been studied in pneumonia or skin infection - those need twice-daily dosing." ], "peds_mgkg_low": 14.0, "peds_mgkg_high": 14.0, "peds_max_mg": 600.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "14 mg/kg/day in 1 or 2 divided doses, maximum 600 mg/day, for 10 days. Suspension 125 mg/5 mL and 250 mg/5 mL. If creatinine clearance is below 30 mL/min/1.73 m2, give 7 mg/kg once daily to a maximum of 300 mg/day.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 140, "high_mg": 140, "capped": false }, { "weight_kg": 20, "low_mg": 280, "high_mg": 280, "capped": false }, { "weight_kg": 30, "low_mg": 420, "high_mg": 420, "capped": false }, { "weight_kg": 40, "low_mg": 560, "high_mg": 560, "capped": false } ], "brands": [ { "trade_name": "CEDENIR 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 45.0, "pack_count": 10, "unit_price": 4.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SPECTRACEFOCURE 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > EVERCURE COMPANY-EGYPT", "price_egp": 45.0, "pack_count": 10, "unit_price": 4.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MERBACTADIN 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SHIFA MEDICAL PRODUCTS > MASH PREMIERE", "price_egp": 52.5, "pack_count": 10, "unit_price": 5.25, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DENROCEF 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SHIFA MEDICAL PRODUCTS > SPIMACO MISR", "price_egp": 67.5, "pack_count": 10, "unit_price": 6.75, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFATHIRD 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 90.0, "pack_count": 10, "unit_price": 9.0, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EGYNIR 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC PHARMACEUTICAL INDUSTRIES > EGYPHAR", "price_egp": 100.0, "pack_count": 10, "unit_price": 10.0, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMNICEF 300 MG 10 CAP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL JAZEERA PHARMACEUTICAL > HIKMA PHARMA", "price_egp": 232.0, "pack_count": 10, "unit_price": 23.2, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TORBENER 300MG 10 H.G. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA PHARMACEUTICALS COMPANY > UTOPIA", "price_egp": 157.0, "pack_count": null, "unit_price": null, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEDENIR 125MG/5ML DRY SUSP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 30.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "AVEROFECTAN 250MG/5ML SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SHIFA MEDICAL PRODUCTS > AVERROES PHARMA-EGYPT", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" }, { "id": 72, "generic": "Azithromycin", "line": 3, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "No adult dose for acute otitis media appears in any source cited for it. The Egyptian formulary lists acute otitis media as an azithromycin indication but doses it in adults only for COPD exacerbation, pneumonia, sexually transmitted infection and strep pharyngitis; the disease article gives only the paediatric 10 mg/kg single dose. For a penicillin-allergic adult, cefdinir carries a sourced adult dose.", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (azithromycin monograph)", "rationale": "Macrolide antibiotic reserved for patients with penicillin allergy; rising resistance among the usual otitis media pathogens is why it sits behind, rather than alongside, the penicillin-based options.", "cautions": [ "Rising macrolide resistance - reserve for penicillin allergy.", "The formulary's general paediatric regimen is 10-12 mg/kg on day 1 (max 500 mg) then 5-6 mg/kg once daily (max 250 mg). The flat five-day course here is the streptococcal-pharyngitis regimen and is deliberately different.", "Azithromycin prolongs the QT interval, so use caution with other QT-prolonging drugs." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Oral: 10 to 12 mg/kg/dose once on day 1 (usual maximum dose: 500 mg/dose) followed by 5 to 6 mg/kg once daily (usual maximum dose: 250 mg/dose) for remainder of treatment duration.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "AZATRIBACT 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 13.5, "pack_count": 3, "unit_price": 4.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GIGAZOCIN 500MG 5 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > PIONEER", "price_egp": 27.5, "pack_count": 5, "unit_price": 5.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SYSTYMYCIN 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > NOVELL PHARMA", "price_egp": 21.5, "pack_count": 3, "unit_price": 7.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZITHROMASH 500 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 48.0, "pack_count": 3, "unit_price": 16.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZALIDE 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 52.0, "pack_count": 3, "unit_price": 17.33, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZROLID 500 MG 6 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 126.0, "pack_count": 6, "unit_price": 21.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZERAMERATE 500 MG", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > GAMMA PHARMA", "price_egp": 28.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISTABCIN 500 MG 3 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHRODOSE 100MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > AVERROES PHARMA-EGYPT", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROPHATE 200MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANO PHARMA > NOVELL PHARMA", "price_egp": 12.75, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" }, { "id": 75, "generic": "Ceftriaxone", "line": 3, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "1 to 2 g once daily by intramuscular or intravenous injection", "adult_duration": "3 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (ceftriaxone monograph) - verbatim: \"General Adult Dosage IV or IM 1-2 g once or devided twice daily.\"", "rationale": "Vomiting is the common reason an ear infection goes untreated in a small child. A three-day intramuscular course, given in the clinic, is the article's named alternative, and the formulary lists acute otitis media among ceftriaxone's indications.", "cautions": [ "Do not give it to a child who has had anaphylaxis to ceftriaxone, any cephalosporin, a penicillin or any other beta-lactam.", "This is a rescue route, not a replacement for the oral course - go back to oral amoxicillin as soon as the child can keep it down." ], "peds_mgkg_low": 50.0, "peds_mgkg_high": 50.0, "peds_max_mg": 1000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "50 mg/kg once a day for 3 days, IM or IV. The formulary caps a mild-to-moderate daily dose at 1,000 mg.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 500, "high_mg": 500, "capped": false }, { "weight_kg": 20, "low_mg": 1000, "high_mg": 1000, "capped": false }, { "weight_kg": 30, "low_mg": 1000, "high_mg": 1000, "capped": true }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 1000, "capped": true } ], "brands": [ { "trade_name": "CEFAXONE 250MG I.V. VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFOTRIX 250MG I.V.VIAL (U.S.P.23)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIXOMASH 500MG VIAL FOR I.V. INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > MASH PREMIERE", "price_egp": 16.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 500MG VIAL FOR I.M. INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 36.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WINTRIAXONE 1 GM PD. FOR I.M INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFTRIAXONE-SANDOZ 500 MG I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B > SANDOZ", "price_egp": 62.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 1 GM I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 106.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 1 GM I.V VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 106.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" }, { "id": 73, "generic": "Paracetamol", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g three or four times daily, maximum 4 g in 24 hours", "adult_duration": null, "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "The ear pain is what brought the child in, and it needs treating whether or not an antibiotic is written - AAFP's otitis media review says management should begin with adequate analgesia and that analgesics are recommended for ear pain, fever and irritability. The dose here is the drug reference's, not the guideline's.", "cautions": [ "Give it at bedtime as well - disturbed sleep is usually what makes the parent come back.", "Check every other product the child is taking for paracetamol. Cold and flu sachets are the usual route to an accidental overdose.", "Reduce the maximum in liver disease, and in a child with severe acute malnutrition (10 mg/kg up to three times in 24 hours).", "500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case." ], "peds_mgkg_low": 15.0, "peds_mgkg_high": 15.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "15 mg/kg per dose three or four times daily from 1 month of age, maximum 60 mg/kg/day. Under 1 month, 10 mg/kg per dose three or four times daily, maximum 40 mg/kg/day.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 150, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 450, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 500, "high_mg": 500, "capped": true } ], "brands": [ { "trade_name": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" }, { "id": 74, "generic": "Ibuprofen", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "200-400 mg up to three times daily with or after food, maximum 1200 mg in 24 hours", "adult_duration": null, "dose_source": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)", "rationale": "AAFP's otitis media review prefers ibuprofen to paracetamol here, for its longer duration of action and lower toxicity in overdose. The dose is the drug label's.", "cautions": [ "Avoid in asthma, active peptic ulcer, dehydration or renal impairment, and in the third trimester of pregnancy.", "Do not give an NSAID in suspected chickenpox or dengue - both can present with fever, and both raise serious risk.", "With food. In a child aged 3-5 months seek advice if symptoms last beyond 24 hours." ], "peds_mgkg_low": 20.0, "peds_mgkg_high": 20.0, "peds_max_mg": null, "peds_basis": "day", "peds_unit": "mg", "peds_note": "20 mg/kg/day in divided doses for pain and fever. Label bands: 3-6 months (over 5 kg) 50 mg three times daily; 6-12 months 50 mg three to four times daily; 1-4 years 100 mg three times daily; 4-7 years 150 mg three times daily; 7-12 years 200 mg three times daily. Not under 3 months. From 12 years use the adult dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "3 to 5 months", "age_min_months": 3, "age_max_months": 5, "dose_text": "50 mg three times daily, and only over 5 kg. Not under 3 months." }, { "label": "6 to 11 months", "age_min_months": 6, "age_max_months": 11, "dose_text": "50 mg three to four times daily" }, { "label": "1 to 3 years", "age_min_months": 12, "age_max_months": 47, "dose_text": "100 mg three times daily" }, { "label": "4 to 6 years", "age_min_months": 48, "age_max_months": 83, "dose_text": "150 mg three times daily" }, { "label": "7 to 11 years", "age_min_months": 84, "age_max_months": 143, "dose_text": "200 mg three times daily" }, { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "The adult dose." } ], "peds_doses": [ { "weight_kg": 10, "low_mg": 200, "high_mg": 200, "capped": false }, { "weight_kg": 20, "low_mg": 400, "high_mg": 400, "capped": false }, { "weight_kg": 30, "low_mg": 600, "high_mg": 600, "capped": false }, { "weight_kg": 40, "low_mg": 800, "high_mg": 800, "capped": false } ], "brands": [ { "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-otitis-media" } ] }