This protocol applies to uncomplicated acute mastoiditis presenting with fluid in the mastoid air cells (non-invasive), in a patient with a documented history of severe allergy — specifically anaphylaxis — to penicillins. Standard penicillin-based first-line regimens are contraindicated in this setting.
Because penicillin-class antibiotics cannot be safely used, this protocol specifies an alternative intravenous antibiotic regimen appropriate for this patient population, with dosing that varies by patient age group. The complete protocol — including agent, age-stratified dosing, and criteria for step-down to oral therapy — is available via the structured regimen below.
Demonstrated clinical improvement of acute mastoiditis within 48–72 hours of initiating therapy.