Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What is the first-line treatment for perforated otitis media?

Amoxicillin
Azithromycin
Ciprofloxacin
Clindamycin

The correct answer is: Amoxicillin

The first-line treatment for perforated otitis media is amoxicillin, which is a widely used antibiotic effective against the common pathogens responsible for this condition. Perforated otitis media often arises from bacterial infections that frequently involve Streptococcus pneumoniae or Haemophilus influenzae. Amoxicillin is favored due to its spectrum of activity, safety profile, and efficacy in treating these specific organisms. When considering other antibiotic options, azithromycin is typically used for patients allergic to penicillin or in cases where resistant strains are suspected, but it is not the first-line choice. Ciprofloxacin is generally reserved for cases of refractory infections and specific organisms that are not covered by amoxicillin. Clindamycin is effective against certain resistant strains and anaerobic bacteria but is not routinely the first choice for typical otitis media cases. The choice of amoxicillin underscores its effectiveness, safety, and the standard practice guidelines recommending it as the initial treatment strategy for perforated otitis media.