Five-day twice daily cefdinir therapy for acute otitis media: microbiologic and clinical efficacy.

Abstract

OBJECTIVE:

To examine the microbiologic and clinical efficacy of a 5-day course of cefdinir in the treatment of tympanocentesis-documented acute otitis media (AOM).

DESIGN:

Open label noncomparative trial.

SETTING:

Primary care, ambulatory.

PATIENTS:

Children ages 6 months through 12 years with signs of AOM and middle ear effusion confirmed by tympanometry in at least one ear.

INTERVENTION:

Patients underwent tympanocentesis at baseline and received cefdinir 7 mg/kg twice a day for 5 days.

MAIN OUTCOME MEASURES:

Presumptive eradication of middle ear pathogens determined by clinical cure of signs and symptoms of AOM at end of therapy (Study Days 7 to 9) and Visit 3 (Study Days 16 to 21).

RESULTS:

A total of 125 of 177 enrolled children had 134 pathogens isolated by tympanocentesis: Streptococcus pneumoniae, 69 (51.5%); Haemophilus influenzae 44 (32.8%; beta-lactamase-positive in 18 of 44 strains); beta-lactamase-positive Moraxella catarrhalis, 15 (11.2%); and Streptococcus pyogenes, 6 (4.5%). The clinical cure rates by patient in the microbiologically and overall clinically evaluable groups, respectively, were 73% (84 of 115) and 77.4% (130 of 168) at the end of therapy visit and 57.4% (66 of 115) and 61.9% (104 of 168) at Visit 3. Presumptive eradication rates at end of therapy were 8 of 11 (72.7%) and 4 of 8 (50%) for patients with penicillin-intermediate and -resistant S. pneumoniae isolates, respectively. Adverse reactions occurred in 16% of patients, with diarrhea (11%) occurring most frequently.

CONCLUSIONS:

A 5-day regimen of cefdinir was effective in the eradication of the common causative pathogens of nonrefractory AOM, including intermediate penicillin-resistant S. pneumoniae and beta-lactamase-producing organisms. Cefdinir should be considered a suitable second line antibiotic for AOM.

• Authors: S L Block, J A Hedrick, J Kratzer, M A Nemeth, K J Tack
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 19 Issue 12 Suppl Pg. S153-8 (Dec 2000) ISSN: 0891-3668 [Print] United States
• PMID: 11144397 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cephalosporins
• Cefdinir

Topics

• Acoustic Impedance Tests
• Acute Disease
• Bacterial Infections (drug therapy, microbiology)
• Cefdinir
• Cephalosporins (pharmacology, therapeutic use)
• Child
• Child, Preschool
• Female
• Haemophilus influenzae (drug effects, isolation & purification)
• Humans
• Infant
• Male
• Microbial Sensitivity Tests
• Moraxella catarrhalis (drug effects, isolation & purification)
• Otitis Media (diagnosis, drug therapy, microbiology)
• Otitis Media with Effusion (diagnosis, drug therapy)
• Penicillin Resistance
• Streptococcus pneumoniae (drug effects, isolation & purification)
• Streptococcus pyogenes (drug effects, isolation & purification)
• Treatment Outcome