This protocol covers the management of non-invasive acute mastoiditis where fluid is present in the mastoid air cells, in patients who have no history of severe allergy (anaphylaxis) to penicillins.
Uncomplicated acute mastoiditis confirmed by fluid in the mastoid air cells (non-invasive presentation), with no prior anaphylactic reaction to penicillins. The absence of a severe penicillin allergy is a defining feature of this protocol — a different pathway applies when that allergy is present.
Management begins with intravenous antibiotic therapy, with consideration of targeted laboratory workup at presentation.
Clinical improvement within 48–72 hours, which serves as the decision point for the next step in the management algorithm.