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Cefaclor v Amoxicillin in Treatment of Acute Otitis Media

Cefaclor v Amoxicillin in Treatment of Acute Otitis Media Abstract • A randomized clinical trial compared cefaclor and amoxicillin for the treatment of acute otitis media (AOM). Twenty-four (77%) of the 31 examinable patients treated with cefaclor and 25 (83%) of the 30 examinable patients treated with amoxicillin had resolution of signs and symptoms after completing a ten- to 14-day course of the antibiotic. Patients who had bilateral AOM, serous or mucold middle ear effusion, Hemophilus influenzae cultured from effusion, or more than five previous otitis media episodes, or who were 3 years of age or younger were more likely to fail treatment. Hemophilus influenzae isolated from effusion were significantly less susceptible to cefaclor than amoxicillin, but none of the 12 treatment failures were caused by antibiotic-resistant infections. Eight (36%) of the 22 patients who recovered after treatment and were reexamined one to three weeks later experienced recurrent AOM. Ear-specific, as well as patient-specific, analyses showed no significant differences between cefaclor and amoxicillin. (AJDC 1984;138:287-292) References 1. Shurin PA, Pelton SI, Donner A, et al: Trimethoprim-sulfamethoxazole compared with ampicillin in the treatment of acute otitis media . J Pediatr 1980;96:1081-1087.Crossref 2. Schwartz RH: Bacteriology of otitis media: A review . Otolaryngol Head Neck Surg 1981; 89:444-450. 3. Lim DJ, Lewis DM, Schram JL, et al: Antibiotic-resistant bacteria in otitis media with effusion . Ann Otol Rhinol Laryngol 1980;98 ( (suppl 68) ):278-280. 4. Shurin PA, Marchant CD, Kim CH, et al: Emergence of beta-lactamase-producing strains of Branhamella catarrhalis as important agents of acute otitis media . Pediatr Infect Dis 1983; 2:34-38.Crossref 5. Kovatch AL, Wald ER, Michaels RH: Betalactamase-producing Branhamella catarrhalis causing otitis media in children . J Pediatr 1983; 102:261-264.Crossref 6. Senturia BH: Classification of middle ear effusions . Ann Otol Rhinol Laryngol 1976;85 ( (suppl 25) ):15-17. 7. Washington JA II, Sutter VL: Dilution susceptibility test: Agar and macro-broth dilution procedures , in Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1980, pp 453-458. 8. Cantekin EI, Bluestone CD, Fria TJ, et al: Identification of otitis media with effusion in children . Ann Otol Rhinol Laryngol 1980;89 ( (suppl 68) ):190-195. 9. Krause PJ, Owens NJ, Nightingale CH, et al: Penetration of amoxicillin, cefaclor, erythromycin-sulfisoxazole, and trimethoprim-sulfamethoxazole into the middle ear fluid of patients with chronic serous otitis media . J Infect Dis 1982;145:815-821.Crossref 10. Lildholdt T, Cantekin EI, Marshak G, et al: Pharmacokinetics of cefaclor in chronic middle ear effusions . Ann Otol Rhinol Laryngol 1981;90( (suppl 84) ):44-47. 11. Mandel EM, Bluestone CD, Cantekin EI, et al: Comparison of cefaclor and amoxicillin for acute otitis media with effusion . Ann Otol Rhinol Laryngol 1981;90( (suppl 84) ):48-52. 12. Nelson JD, Ginsburg CM, Clahsen JC: Treatment of acute otitis media of infancy with cefaclor . AJDC 1978;132:992-996. 13. Mandel EM, Bluestone CD, Rockette HE, et al: Deviation of effusion after antibiotic treatment for acute otitis media: Comparison of cefaclor and amoxicillin . Pediatr Infect Dis 1982; 1:310-316.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Cefaclor v Amoxicillin in Treatment of Acute Otitis Media

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1984.02140410065020
Publisher site
See Article on Publisher Site

Abstract

Abstract • A randomized clinical trial compared cefaclor and amoxicillin for the treatment of acute otitis media (AOM). Twenty-four (77%) of the 31 examinable patients treated with cefaclor and 25 (83%) of the 30 examinable patients treated with amoxicillin had resolution of signs and symptoms after completing a ten- to 14-day course of the antibiotic. Patients who had bilateral AOM, serous or mucold middle ear effusion, Hemophilus influenzae cultured from effusion, or more than five previous otitis media episodes, or who were 3 years of age or younger were more likely to fail treatment. Hemophilus influenzae isolated from effusion were significantly less susceptible to cefaclor than amoxicillin, but none of the 12 treatment failures were caused by antibiotic-resistant infections. Eight (36%) of the 22 patients who recovered after treatment and were reexamined one to three weeks later experienced recurrent AOM. Ear-specific, as well as patient-specific, analyses showed no significant differences between cefaclor and amoxicillin. (AJDC 1984;138:287-292) References 1. Shurin PA, Pelton SI, Donner A, et al: Trimethoprim-sulfamethoxazole compared with ampicillin in the treatment of acute otitis media . J Pediatr 1980;96:1081-1087.Crossref 2. Schwartz RH: Bacteriology of otitis media: A review . Otolaryngol Head Neck Surg 1981; 89:444-450. 3. Lim DJ, Lewis DM, Schram JL, et al: Antibiotic-resistant bacteria in otitis media with effusion . Ann Otol Rhinol Laryngol 1980;98 ( (suppl 68) ):278-280. 4. Shurin PA, Marchant CD, Kim CH, et al: Emergence of beta-lactamase-producing strains of Branhamella catarrhalis as important agents of acute otitis media . Pediatr Infect Dis 1983; 2:34-38.Crossref 5. Kovatch AL, Wald ER, Michaels RH: Betalactamase-producing Branhamella catarrhalis causing otitis media in children . J Pediatr 1983; 102:261-264.Crossref 6. Senturia BH: Classification of middle ear effusions . Ann Otol Rhinol Laryngol 1976;85 ( (suppl 25) ):15-17. 7. Washington JA II, Sutter VL: Dilution susceptibility test: Agar and macro-broth dilution procedures , in Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1980, pp 453-458. 8. Cantekin EI, Bluestone CD, Fria TJ, et al: Identification of otitis media with effusion in children . Ann Otol Rhinol Laryngol 1980;89 ( (suppl 68) ):190-195. 9. Krause PJ, Owens NJ, Nightingale CH, et al: Penetration of amoxicillin, cefaclor, erythromycin-sulfisoxazole, and trimethoprim-sulfamethoxazole into the middle ear fluid of patients with chronic serous otitis media . J Infect Dis 1982;145:815-821.Crossref 10. Lildholdt T, Cantekin EI, Marshak G, et al: Pharmacokinetics of cefaclor in chronic middle ear effusions . Ann Otol Rhinol Laryngol 1981;90( (suppl 84) ):44-47. 11. Mandel EM, Bluestone CD, Cantekin EI, et al: Comparison of cefaclor and amoxicillin for acute otitis media with effusion . Ann Otol Rhinol Laryngol 1981;90( (suppl 84) ):48-52. 12. Nelson JD, Ginsburg CM, Clahsen JC: Treatment of acute otitis media of infancy with cefaclor . AJDC 1978;132:992-996. 13. Mandel EM, Bluestone CD, Rockette HE, et al: Deviation of effusion after antibiotic treatment for acute otitis media: Comparison of cefaclor and amoxicillin . Pediatr Infect Dis 1982; 1:310-316.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Mar 1, 1984

References