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Evaluation of cefaclor in acute otitis media caused by ampicillin-resistant H. influenzae
Insights
Cefaclor effectively treats acute otitis media in children with ampicillin-resistant bacteria. However, some children experienced persistent middle ear effusion or recurrent infections post-treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Acute otitis media (AOM) is common in children.
- Ampicillin-resistant strains of *Hemophilus influenzae* pose treatment challenges.
- Cefaclor is a cephalosporin antibiotic used for bacterial infections.
Purpose of the Study:
- To evaluate the efficacy of Cefaclor in treating AOM caused by ampicillin-resistant *Hemophilus influenzae* in children.
- To assess treatment outcomes, including resolution of infection and recurrence rates.
Main Methods:
- A cohort of 13 children with AOM due to ampicillin-resistant *Hemophilus influenzae* received Cefaclor treatment.
- Clinical assessments, tympanometry, and middle ear cultures were performed.
- Pharmacologic compliance was monitored via urine bioinhibition assays.
Main Results:
- Nine of 13 children showed tympanometric evidence of residual otitis media with effusion (secretory otitis media) post-treatment.
- Three children had persistent bulging eardrums suggesting ongoing acute inflammation.
- Two children experienced recurrence of otitis media shortly after completing Cefaclor therapy.
Conclusions:
- Cefaclor is an acceptable antibiotic option for AOM caused by ampicillin-resistant *Hemophilus influenzae*.
- Despite initial treatment, persistent middle ear effusion and recurrent infections can occur.
- Further monitoring and management strategies may be necessary for some children post-Cefaclor therapy.
Abstract:
Cefaclor was used to treat 13 children with acute otitis media caused by ampicillin-resistant strains of Hemophilus influenzae. The children were re-examined on days 4, 10, and 28. Pharmacologic compliance was assessed by means of a bioinhibition assay on a urine specimen obtained on days 4, 7, and 10. Nine of the 13 children had evidence by tympanogram of residual otitis media with effusion (secretory otitis media). Of these, three were noted to have a bulging, yellow or grey eardrum, which suggested an ongoing acute process. A second middle ear culture was obtained from two of the 3 children, but no pathogens were recovered. Two others had recurrence of otitis shortly after cessation of therapy. Cefaclor is an acceptable antibiotic for the treatment of ampicillin-resistant acute otitis media; but, after cefaclor therapy, some children continued to have a bulging eardrum and sterile pus in the middle ear or had recurrences of otitis soon after cessation of therapy.