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Treatment of acute otitis media of infancy with cefaclor
Abstract:
The emergence of ampicillin-resistant Haemophilus as a clinical problem in otitis media necessitates a search for alternative, effective therapy. An orally absorbable cephalosporin derivative, cefaclor, is equally effective in vitro against ampicillin-susceptible and -resistant Haemophilus and against other bacteria that cause acute otitis media. Two dosage schedules of cefaclor (40 and 60 mg/kg/day) were evaluated in 95 infants with acute otitis media. Bacterial origin was determined by a culture of tympanocentesis fluid. Success rates using the smaller dosage were inferior to those using the larger dosage. Results of therapy for pneumococcal and Haemophilus infection with 60 mg/kg/day were comparable to those previously found with amoxicillin trihydrate or with combinations of trisulfapyrimadines with erythromycin or penicillin V. One patient with an ampicillin-resistant Haemophilus infection responded well to cefaclor and did not have a relapse. Cefaclor was well tolerated and caused an acceptably low incidence of minor, adverse effects. Cefaclor deserves further testing as a candidate for preferred status as a single-drug treatment of acute otitis media.
Insights
Cefaclor shows promise as an effective treatment for acute otitis media, even against ampicillin-resistant bacteria. Higher cefaclor dosages (60 mg/kg/day) demonstrated superior efficacy in infants, with good tolerability.
Area of Science:
- Infectious Diseases
- Pediatrics
- Pharmacology
Background:
- Ampicillin-resistant Haemophilus poses a significant challenge in treating acute otitis media.
- There is a need for alternative, effective oral therapies for bacterial ear infections.
Purpose of the Study:
- To evaluate the efficacy and tolerability of cefaclor in infants with acute otitis media.
- To compare two different cefaclor dosage regimens (40 and 60 mg/kg/day).
Main Methods:
- A clinical trial involving 95 infants diagnosed with acute otitis media.
- Bacterial pathogens were identified through tympanocentesis fluid cultures.
- Treatment outcomes were assessed for different cefaclor dosages and bacterial types.
Main Results:
- The higher cefaclor dosage (60 mg/kg/day) showed superior success rates compared to the lower dosage.
- Cefaclor demonstrated efficacy against both ampicillin-susceptible and -resistant Haemophilus strains.
- Therapeutic outcomes with 60 mg/kg/day cefaclor were comparable to established treatments like amoxicillin.
Conclusions:
- Cefaclor is an effective and well-tolerated oral antibiotic for acute otitis media in infants.
- A dosage of 60 mg/kg/day is recommended for optimal therapeutic outcomes.
- Cefaclor warrants further investigation as a potential first-line single-drug therapy for acute otitis media.