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Cephalexin compared to ampicillin treatment of otitis media
Abstract:
Cephalexin was compared to ampicillin for the treatment of otitis media in a randomized study. Bacteriologic diagnosis was sought by needle tympanocentesis in 179 children. No overall statistically significant differences were noted between the two groups; however, 20 patients who received cephalexin had a poor response to therapy whereas only five recipients of ampicillin responded poorly. A significant difference (P less than .05) between the two regimens was noted when Hemophilus influenzae was recovered. Fifty per cent of the children with H. influenzae otitis media who were treated with cephalexin responded poorly; no patients receiving ampicillin had a poor response. Our data suggest that the use of cephalexin monohydrate is not warranted for treatment of otitis media due to H. influenzae even when the isolate proves sensitive to this drug in vitro. In selected patients with otitis media caused by Staphylococcus aureus which is resistant to penicillin, cephalexin may provide effective treatment.
Insights
Cephalexin is not recommended for treating otitis media caused by Haemophilus influenzae, even if the bacteria appear sensitive. Ampicillin showed better outcomes in this specific bacterial infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Otitis media is a common childhood infection.
- Antibiotic resistance is a growing concern in treating otitis media.
- Evaluating the efficacy of different antibiotics is crucial for effective treatment.
Purpose of the Study:
- To compare the efficacy of cephalexin and ampicillin in treating otitis media.
- To assess treatment outcomes based on specific bacterial pathogens.
- To determine the suitability of cephalexin for *Haemophilus influenzae* infections.
Main Methods:
- A randomized study involving 179 children with otitis media.
- Bacteriologic diagnosis was confirmed via needle tympanocentesis.
- Patients were treated with either cephalexin or ampicillin.
Main Results:
- No overall significant difference in treatment outcomes between cephalexin and ampicillin.
- A higher rate of poor response to cephalexin (20 patients) compared to ampicillin (5 patients).
- A statistically significant difference in treatment failure for *Haemophilus influenzae* infections, with 50% of cephalexin recipients responding poorly versus 0% for ampicillin.
Conclusions:
- Cephalexin monohydrate is not recommended for otitis media caused by *Haemophilus influenzae*, irrespective of in vitro sensitivity.
- Ampicillin demonstrated superior efficacy against *H. influenzae* otitis media in this study.
- Cephalexin may be a viable option for penicillin-resistant *Staphylococcus aureus* otitis media.