You are currently viewing Acute Mastoiditis – Mnemonic

Here is a quick mnemonic “ANTIBIOTIC THERAPY to remember about Acute Mastoiditis

This can be valuable for patients as well as medical doctors, nurses & students doing their clinical rounds. You can also find it very useful for med exams like USMLE, MBBS, NEET PG, FMGE, NExT, MCAT & NCLEX exams

Acute Mastoiditis : How To Remember Easily ?

  • A – ACUTE MASTOIDITIS: A serious infection with significant morbidity despite antibiotic and surgical treatment.
  • N – Neutrophilia: Elevation of inflammatory markers and white blood cells with neutrophilia.
  • T – Treatment: Patients with mastoiditis should be admitted to the hospital and treated with IV antibiotics and myringotomy, with or without tympanostomy tubes.
  • I – Involves Spread: The pathogenesis of mastoiditis involves spread of organisms from the middle-ear spaces through the aditus ad antrum to the mastoid air cells.
  • B – Bezold’s Abscess: An abscess medial to the sternocleidomastoid that tracks into the deep cervical fascia, which is a complication of mastoiditis.
  • I – Imaging: CT and MRI with gadolinium are used for imaging to assess the severity and complications of mastoiditis.
  • O – Organisms: The organisms commonly involved in mastoiditis are S. pneumoniae, Streptococcus pyogenes, H. influenzae, S. aureus (including MRSA strains), and P. aeruginosa.
  • T – Tubes and Myringotomy: Tympanostomy or myringotomy samples or subperiosteal abscess drainage should be sent for culture and sensitivity testing.
  • I – Infection: Acute mastoiditis is a serious infection with potential complications such as facial nerve palsy, labyrinthitis, and meningitis.
  • C – Culture and Sensitivity: Culture and sensitivity results will guide antibiotic changes in the treatment of mastoiditis.
  • T – 7-10 Days: IV antibiotic therapy should be continued for 7–10 days, and patients should complete a 4-week course of oral antibiotics.
  • H – History and Presentation: Imaging is not necessary in children with a classic history and presentation of mastoiditis.
  • E – Etiology: Acute mastoiditis is often a complication of AOM but may develop without clinically apparent, prior AOM.
  • R – Recurrent AOM: Patients with recurrent AOM or recent antibiotic treatment should be given vancomycin plus an antipseudomonal penicillin.
  • A – Abscess: Mastoiditis often causes subperiosteal abscess laterally.
  • P – Progression: Incipient mastoiditis can progress to coalescent mastoiditis with destruction of the bony septa.
  • Y – Young Children: Acute mastoiditis is most common among children <2 years old but can occur at any age.


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department