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Cardiovascular

Abdominal pain in kids

Abnormal/Dysfunctional Uterine Bleeding (AUB/DUB)

Acanthosis Nigricans

Actinic Cheilitis

Acute Kidney Injury (AKI)

Acute Swollen Joint with Fever

Acute Vision Loss

Acute and Progressive Vision Loss

Adjustment Disorder and Anxiety

Adjustment Disorder with Depressed Mood

Age related macular degeneration

Alcohol Cessation

Allergic rhinitis

Angular Cheilitis

Ankylosing Spondylitis (AS)

Anorexia Nervosa

Anticholinergics and TCAs

Antidepressants

Antimetabolite drugs

Antiphospholipid syndrome

Anxiety Disorders

Aortic Dissection

Atrial Fibrillation

Behavioural / learning disorders

Behavioural disturbances

Bell’s palsy and Ramsey Hunt syndrome

Beta-Human Chorionic Gonadotropin (β-hCG)

Biologic agents

Bipolar Disorder

Bleeding disorders

Bronchiectasis (Updated)

CA-125 (Cancer Antigen 125)

CVD Risk Assessment

Calluses and Corns

Candida (Candidiasis as an STI)

Carpal tunnel syndrome and de quervains tenosynovitis

Cervical spondylosis

Chickenpox (Varicella)

Chronic Cough in Children

Chronic Fatigue Syndrome (CFS)

Chronic Kidney Disease (CKD)

Chronic Rhinosinusitis

Chronic Stridor

Clavicular fracture

Colorectal Cancer Screening Recommendations

Congestive Cardiac Failure

Connective Tissue Diseases

Contact Dermatitis

Cutaneous Drug Eruptions

Dacrocystitis, dacyrostenosis, dacyrocystocoele

Deep Vein Thrombosis (DVT)

Depression and Delirium

Dermal melanocystosis (mongolian spot)

Developmental Dysplasia of the Hip (DDH)

Diabetes Insipidus (DI) vs Primary Polydipsia

Diabetic Neuropathy

Dizziness / syncope

Duchenne muscular dystrophy

Dupuytrens / trigger finger

Dyspnoea (Shortness of Breath)

Otitis Media

When to Use Antibiotics

Persistent/worsening symptoms >48 hours.
Age <6 months.
ATSI patients (higher risk).
Bilateral OM in children <2 years.
Fever, lethargy, or systemic signs.
Otorrhoea or perforated tympanic membrane.
Single hearing ear or cochlear implant.

First-Line Treatment

Amoxicillin: 15 mg/kg TDS (max 500 mg) for 5 days.
- ATSI: 50 mg/kg/day for 7 days; increase to 90 mg/kg/day for bulging TM.

Alternatives

Mild penicillin allergy: Cefuroxime 15 mg/kg BD (max 500 mg) for 5 days.
Severe penicillin allergy: Trimethoprim + Sulfamethoxazole 4+20 mg/kg BD (max 160+800 mg) for 5 days.

Recurrent OM or recent antibiotics

Amoxicillin + Clavulanate (Augmentin DF): BD for 5–7 days.

Follow-Up

Return if no improvement after 48–72 hours.
Monitor hearing after 2–3 months (OMwE risk).

ATSI Considerations

Higher risk of chronic suppurative OM; treat aggressively.
Antibiotics always for bulging TM or single hearing ears.
Minimum 7-day antibiotic course.

When to Escalate

No improvement after 48–72 hours: Switch to Amoxicillin + Clavulanate.
Recurrent OM (>3 episodes in 6 months or >4 in 12 months): ENT referral for grommets.

Otitis Media

Criteria for Antibiotics (AB):

Symptoms persist or worsen after 48 hours.
Age <6 months.
ATSI patients (higher risk of complications).
Bilateral OM in children <2 years.
Presence of systemic features (fever, lethargy).
Otorrhoea or perforated tympanic membrane.
Single hearing ear or cochlear implant (per RCH).

Pharmacological Management:

First-line:
- Amoxicillin 15mg/kg TDS (max 500mg) for 5 days.
- ATSI patients: 50mg/kg/day for 7 days; if bulging persists, escalate to 90mg/kg/day for a further 7 days.
If mild penicillin allergy:
- Cefuroxime 15mg/kg BD (max 500mg) for 5 days.
If severe penicillin allergy:
- Trimethoprim + Sulfamethoxazole 4+20mg/kg BD (max 160+800mg) for 5 days.
Recurrent OM or recent AB use (last 30 days):
- Amoxicillin + Clavulanate (Augmentin DF) BD for 5–7 days.

Follow-up Recommendations:

Advise parents to return if:
- Persistent symptoms or irritability >48–72 hours.
- Symptoms suggestive of hearing loss (may indicate Otitis Media with Effusion - OMwE).
Arrange 2–3-month follow-up to assess hearing.

ATSI-Specific Considerations:

OM more likely to progress to chronic suppurative OM in ATSI populations.
Treat aggressively and monitor closely.
Longer duration of antibiotics (minimum 7 days).
Always prescribe antibiotics for ATSI children with bulging tympanic membranes or single hearing ears.

Step-Up Criteria:

Symptoms fail to improve or worsen after 48–72 hours of initial treatment.
- Switch from amoxicillin to Amoxicillin + Clavulanate (Augmentin DF).
For recurrent OM (>3 episodes in 6 months or >4 in 12 months):
- ENT referral for consideration of tympanostomy tubes (grommets).

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