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Five-day versus ten-day treatment of acute otitis media with cefprozil
D A Kafetzis1, H Astra, L Mitropoulos
1Second Department of Paediatries, P & A Kyriakou Children's Hospital, University of Athens, Athens 11527, Greece.
Insights
A five-day course of cefprozil effectively treats acute otitis media in most children. However, for those with recurrent infections, a ten-day treatment is recommended for better outcomes.
Area of Science:
- Pediatric infectious diseases
- Clinical pharmacology
- Evidence-based medicine
Background:
- Acute otitis media (AOM) is a common pediatric infection.
- Optimizing antibiotic treatment duration is crucial for efficacy and reducing resistance.
- Cefprozil is a widely used antibiotic for AOM.
Purpose of the Study:
- To compare the clinical efficacy and safety of a 5-day versus a 10-day course of cefprozil for treating AOM in children.
- To determine if a shorter treatment duration is non-inferior to a standard duration.
- To evaluate outcomes in specific subgroups, such as children with recurrent AOM.
Main Methods:
- A randomized comparative clinical trial.
- Inrolled 708 pediatric patients with AOM.
- Evaluated clinical outcomes and safety for 5-day and 10-day cefprozil regimens.
Main Results:
- Cefprozil achieved complete efficacy in 87.1% of patients after 5 days and 91.2% after 10 days.
- In patients with 3 or more prior AOM episodes, the 10-day group showed a 100% cure rate, compared to 44% in the 5-day group.
- No significant safety concerns were reported for either treatment duration.
Conclusions:
- A 5-day cefprozil course is effective for uncomplicated AOM.
- For children with a history of recurrent acute otitis media, a 10-day course of cefprozil is recommended for superior outcomes.
- Treatment duration should be individualized based on patient history.
Abstract:
A randomized comparative clinical trial was conducted to investigate the possibility of decreasing the duration of treatment of acute otitis media by comparing the clinical outcome and safety of a five-day and a ten-day course of cefprozil. A total of 708 pediatric patients were enrolled in the study, 560 of whom were evaluable for efficacy. Cefprozil was found to be completely effective in 87.1% of cases after five days of treatment, and in 91.2% after ten days of treatment. Of 19 patients with three or more previous episodes of acute otitis media, ten patients in the ten-day treatment group had a 100% cure rate, while in the five-day group four experienced cure, three improvement, and two failure. A five-day course of treatment with cefprozil can be recommended only if children have no history of recurrent acute otitis media.