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An experimental study of cefixime in the treatment of Streptococcus pneumoniae otitis media
A E Magit1, J N Dolitsky, W J Doyle
1Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, PA 15213-2583.
Abstract:
Previous studies using the chinchilla animal model demonstrated that the third generation cephalosporin cefixime (Suprax) with split dosing was as effective as ampicillin in sterilizing the middle ear cleft when infected with S. pneumoniae. In this investigator-blinded, randomized trial, a single daily dose of cefixime (8 mg/kg per day) performed as well as split dosing of cefixime (8 mg/kg every 8 h) and ampicillin (150 mg/kg every 8 h) in the time to sterilization of the middle ear cleft. No statistically significant differences were noted between groups in otoscopy or tympanometry. All antibiotic regimens performed better than saline control (P < 0.0001) with regard to time to sterilization of the middle ear cleft. The results of this study support the daily administration of cefixime as an effective agent for the treatment of otitis media due to its extended half-life and broad antibiotic spectrum.
Insights
A single daily dose of cefixime effectively treats middle ear infections in chinchillas, matching split-dose cefixime and ampicillin. This supports daily cefixime for otitis media treatment.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pharmacology
Background:
- Otitis media is a common infection.
- Strengths of third-generation cephalosporins like cefixime are well-established.
- Previous research indicated split-dosing of cefixime efficacy.
Purpose of the Study:
- To evaluate the efficacy of a single daily dose of cefixime compared to split dosing and ampicillin for treating otitis media.
- To determine the time to sterilization of the middle ear cleft in an animal model.
Main Methods:
- Investigator-blinded, randomized trial in a chinchilla model.
- Comparison of single daily cefixime (8 mg/kg/day) versus split-dose cefixime (8 mg/kg every 8 hours) and ampicillin (150 mg/kg every 8 hours).
- Inclusion of a saline control group.
Main Results:
- Single daily cefixime demonstrated equivalent efficacy to split-dose cefixime and ampicillin in middle ear sterilization time.
- No significant differences observed in otoscopy or tympanometry between antibiotic groups.
- All antibiotic regimens were significantly more effective than saline control (P < 0.0001).
Conclusions:
- Daily administration of cefixime is an effective treatment strategy for otitis media.
- Cefixime's extended half-life and broad spectrum support its use in a once-daily regimen.
- This study validates simplified dosing regimens for otitis media treatment.