Azidocillin and ampicillin concentrations in middle ear effusion

Area of Science:

• Pharmacology
• Otolaryngology
• Infectious Diseases

Background:

• Acute otitis media (AOM) and secretory otitis media (SOM) are common ear infections.
• Effective antibiotic penetration into middle ear effusion (MEE) is crucial for treatment success.

Purpose of the Study:

• To compare the penetration and persistence of azidocillin and ampicillin into middle ear effusion (MEE) following oral administration in patients with acute otitis media (AOM).
• To compare drug levels in MEE with concurrent blood levels.
• To evaluate the drug penetration in secretory otitis media (SOM).

Main Methods:

• Oral administration of azidocillin (15 mg/kg) and ampicillin (10 mg/kg) to patients with AOM.
• Sampling of middle ear effusion and blood at various time points post-administration.
• Quantification of drug concentrations using established analytical methods.

Main Results:

• Azidocillin and ampicillin concentrations in MEE were significantly higher and persisted longer than in blood after oral administration in AOM.
• Peak concentrations in MEE were observed around 2 hours post-dose for both drugs.
• Drug penetration into MEE was poor in patients with SOM, with significantly lower drug levels.

Conclusions:

• Azidocillin and ampicillin demonstrate favorable penetration and sustained levels in middle ear effusion in acute otitis media.
• The prolonged presence of these antibiotics in MEE supports their efficacy in treating AOM.
• Twice-daily dosing of azidocillin is supported by its pharmacokinetic profile in MEE.
• Antibiotic penetration is compromised in secretory otitis media, suggesting potential challenges in treatment.