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In vivo correlates for Streptococcus pneumoniae penicillin resistance in acute otitis media
Abstract:
Eighty-four children suffering from acute otitis media caused by Streptococcus pneumoniae were treated prospectively with cefuroxime axetil suspension (30 mg/kg of body weight twice daily for 8 days). The high incidence of isolates with decreased susceptibilities to penicillin (42 of 84 isolates) allowed us to establish a relationship between clinical success and the penicillin MICs for pneumococcal isolates. It was found that cefuroxime axetil is clinically effective in the treatment of acute otitis media caused by penicillin-susceptible and penicillin-intermediate strains of S. pneumoniae. The results indicate that the risk of treatment failure with cefuroxime axetil was increased in children with otitis media caused by S. pneumoniae when the penicillin MIC were greater than or equal to 2 mg/liter.
Insights
Cefuroxime axetil effectively treats acute otitis media in children caused by Streptococcus pneumoniae. However, treatment failure risk increases for infections with higher penicillin minimum inhibitory concentrations (MICs).
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Pharmacology
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Streptococcus pneumoniae is a primary causative agent of AOM.
- Increasing penicillin resistance in S. pneumoniae necessitates evaluating alternative antibiotic efficacy.
Purpose of the Study:
- To assess the clinical efficacy of cefuroxime axetil in treating AOM caused by S. pneumoniae.
- To correlate clinical outcomes with penicillin minimum inhibitory concentrations (MICs) of S. pneumoniae isolates.
Main Methods:
- Prospective study involving 84 children with AOM due to S. pneumoniae.
- Treatment administered: cefuroxime axetil suspension (30 mg/kg twice daily for 8 days).
- Susceptibility testing performed, focusing on penicillin MICs for pneumococcal isolates.
Main Results:
- Cefuroxime axetil demonstrated clinical effectiveness against penicillin-susceptible and penicillin-intermediate S. pneumoniae strains.
- 42 of 84 isolates exhibited decreased susceptibility to penicillin.
- Increased risk of treatment failure was observed when penicillin MICs were ≥2 mg/liter.
Conclusions:
- Cefuroxime axetil is a viable treatment option for pediatric AOM caused by susceptible and intermediate S. pneumoniae.
- Penicillin MIC values are important predictors of cefuroxime axetil treatment outcomes.
- Monitoring penicillin MICs is crucial for optimizing antibiotic therapy in AOM.