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Acute otitis media: clinical course among children who received a short course of high dose antibiotic
Insights
A short course of amoxicillin for acute otitis media in children is as effective as a longer course. This finding applies regardless of prior ear infections or eardrum bulging, with similar side effects.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Standard treatment often involves a seven-day course of amoxicillin.
- Optimizing antibiotic duration is crucial for efficacy and reducing resistance.
Purpose of the Study:
- To compare the efficacy of a two-day amoxicillin course versus a seven-day course for AOM in children.
- To evaluate symptom resolution, recurrence rates, and hearing loss associated with different amoxicillin durations.
Main Methods:
- Prospective randomized trial involving 274 children aged 3-10 years with AOM.
- Two treatment arms: 7-day amoxicillin (125 mg TID) vs. 2-day amoxicillin (750 mg BID).
- Follow-up included symptom diaries, clinical examinations, and a one-year assessment for recurrence and hearing loss.
Main Results:
- The two-day amoxicillin course demonstrated comparable efficacy to the seven-day course in resolving AOM symptoms and signs.
- No significant differences were observed in recurrence rates or hearing loss between the groups over a one-year follow-up.
- Adverse events were infrequent and similarly distributed across both treatment regimens.
Conclusions:
- A two-day course of high-dose amoxicillin is a viable and effective alternative for treating acute otitis media in children.
- Shorter antibiotic durations may be considered for AOM, potentially reducing antibiotic exposure without compromising outcomes.
- Further research could explore long-term impacts and cost-effectiveness of shorter regimens.
Abstract:
A prospective study was carried out in 274 children aged 3 to 10 years with acute otitis media. They were randomly allocated to one of two treatment regimens: (a) a seven day course of amoxycillin 125 mg three times a day, and (b) a two day course of amoxycillin 750 mg twice a day. They were followed up by symptom diaries and clinical examination. The findings in the 243 children who completed the trial showed that the short course of treatment was as effective as the seven day course in the speed of resolution of symptoms and signs, irrespective of previous history of otitis media or of episodes in which bulging of the eardrums was observed at presentation. A subgroup of 185 children was followed up for one year after entry to the trial. During this period no appreciable differences emerged between the two antibiotic regimens, either in recurrence rate of otitis media or in the frequency of hearing loss at one month and six months after entry to the study. Side effects of treatment were few, and those that could be attributed to antibiotic use occurred with equal frequency in the two treatment groups.