ENT Updates

Review

Amoxicillin in the Treatment of Mastoiditis: Efficacy, Challenges, and Future Directions

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https://doi.org/10.54963/entu.v16i1.1671
Khalid, W., Alzahrani, M., Alqahtani, G., Mushayt, R., Sinan, A. A., Alsultani, S., Alenezi, A., Alenezi, K., Alanazi, L., Abdullah, T., Abdullah, K., Daban, M., Samah, N., & Farhan, M. (2026). Amoxicillin in the Treatment of Mastoiditis: Efficacy, Challenges, and Future Directions. ENT Updates, 16(1), 1–18. https://doi.org/10.54963/entu.v16i1.1671
Volume 16 Issue 1 (2026)
Copyright (c) 2026 Wajan Khalid, Manar Alzahrani, Ghassan Alqahtani, Razan Mushayt, Ayat Al Sinan, Sadeem Alsultani, Aryam Alenezi, Khawlah Alenezi, Lama Alanazi, Tahani Abdullah, Khadijah Abdullah, Mohammed Daban, Naif Samah, Modhi Farhan
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors

  • Wajan Khalid

    College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Manar Alzahrani

    College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
  • Ghassan Alqahtani

    Department of Pharmacy, AlNahdi Medical Company, Jeddah 21484, Saudi Arabia
  • Razan Mushayt

    Department of Pharmacy, Abha International Private Hospital, Abha 62521, Saudi Arabia
  • Ayat Al Sinan

    College of Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
  • Sadeem Alsultani

    College of Pharmacy, Northern Borders University, Rafha 76413, Saudi Arabia
  • Aryam Alenezi

    Department of Pharmacy Services, Prince Abdulaziz Bin Musaad Hospital, Arar 91451, Saudi Arabia
  • Khawlah Alenezi

    Department of Pharmacy Services, Prince Abdulaziz Bin Musaad Hospital, Arar 91451, Saudi Arabia
  • Lama Alanazi

    Department of Pharmacy Services, Prince Abdulaziz Bin Musaad Hospital, Arar 91451, Saudi Arabia
  • Tahani Abdullah

    Department of Nursing, Northern Area Armed Forces Hospital, Hafar Al Batin 31991, Saudi Arabia
  • Khadijah Abdullah

    Department of Supply, Northern Area Armed Forces Hospital, Hafar Al Batin 31991, Saudi Arabia
  • Mohammed Daban

    Department of Supply, Northern Area Armed Forces Hospital, Hafar Al Batin 31991, Saudi Arabia
  • Naif Samah

    Department of Supply, Northern Area Armed Forces Hospital, Hafar Al Batin 31991, Saudi Arabia
  • Modhi Farhan

    Department of Supply, Northern Area Armed Forces Hospital, Hafar Al Batin 31991, Saudi Arabia

Received: 30 September 2025; Revised: 15 December 2025; Accepted: 20 January 2026; Published: 28 January 2026

Mastoiditis, a serious complication of acute otitis media, primarily affects the pediatric population and requires prompt diagnosis and treatment to prevent severe complications. This review explores the pathophysiology, clinical presentation, diagnostic techniques, and therapeutic approaches for mastoiditis, focusing on the role of amoxicillin in its management. The anatomical connection between the middle ear and mastoid air cells facilitates the spread of infection, which is further influenced by inflammatory processes, bacterial biofilms, and host immune responses. Diagnosis involves a combination of clinical findings, imaging studies such as computed tomography and magnetic resonance imaging, and microbiological cultures to guide targeted antibiotic therapy. Amoxicillin remains the first-line treatment for non-resistant cases owing to its effectiveness against common pathogens, safety profile, and cost efficiency. However, the increasing prevalence of β-lactamase-producing bacteria necessitates the use of amoxicillin-clavulanate in resistant cases. Antibiotic selection should be based on local resistance patterns and patient-specific factors, such as allergies and comorbidities. Surgical interventions, including mastoidectomy, are required in advanced or refractory cases. Future research should focus on developing novel diagnostic tools, optimizing antibiotic regimens, and implementing antimicrobial stewardship programs to combat drug resistance. Global collaboration is essential for establishing standardized guidelines and improving access to high-quality care in resource-limited settings.

Keywords:

Mastoiditis Otitis Media Amoxicillin Antimicrobial Therapy Diagnostic Techniques Imaging Antibiotic Resistance

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