Antibiotics for Acute Otitis Media in the Era of Antibiotic Resistance—What are the Choices?
Otitis media is the most common respiratory tract infection of infancy and early childhood that is managed with antibacterial agents. The bacteriology of otitis media in children is well-known and comprises three main pathogens: Streptococcus pneumoniae, nontypable Haemophilus influenzae, and to a lesser extent, Moraxella catarrhalis (Dagan and Leibovitz, 2002). In patients in whom treatment is warranted, the role of antibiotics is to eradicate the causative organism from the middle ear cavity. To achieve this goal, the antibiotic must be active in vitro against the targeted organisms and must penetrate the middle ear cavity in sufficient concentrations.
KeywordsOtitis Medium Acute Otitis Medium Eradication Rate Clinical Failure Moraxella Catarrhalis
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- Dagan, R., Piglansky, L., Fliss, D.M., Leiberman, A., and Leibovitz, E. (1997b). Bacteriologic response in acute otitis media: comparison between azithromycin, cefaclor and amoxicillin [Abstr. K-103]. In Program and Abstracts of the 37th Conference on antibiotic agents and chemotherapy (ICAAC), Toronto, Ontario. American Society for Microbiology, Washington, DC.Google Scholar
- Dagan, R., Leibovitz, E., Greenberg, D., Yagupsky, P., Fliss, D.M., and Leiberman, A. (1998). Early eradication of pathogens from middle ear fluid during antibiotic treatment of acute otitis media is associated with improved clinical outcome. Pediatr. Infect. Dis. J. 17, 776–782.PubMedCrossRefGoogle Scholar
- Dagan, R., Leibovitz, E., Fliss, D.M., Leiberman, A., Jacobs, M.R., Craig, W., and Yagupsky, P. (2000b). Bacteriologic efficacies of oral azithromycin and oral cefaclor in treatment of acute otitis media in infants and young children. Antimicrob. Agents Chemother. 44, 43–50.PubMedCrossRefGoogle Scholar
- Howie, V.M. and Ploussard, J.H. (1972). Efficacy of fixed combination antibiotics versus separate components in otitis media. Effectiveness of erythromycin estrolate, triple sulfonamide, ampicillin, erythromycin estolate-triple sulfonamide, and placebo in 280 patients with acute otitis media under two and one-half years of age. Clin. Pediatr. (Phila). 11, 205–214.CrossRefGoogle Scholar
- Leibovitz, E., Piglansky, L., Raiz, S., Press, J., Leiberman, A., and Dagan, R. (2000). Bacteriologic and clinical efficacy of one day vs. three day intramuscular ceftriaxone for treatment of nonresponsive acute otitis media in children. Pediatr. Infect. Dis. J. 19, 1040–1045.PubMedCrossRefGoogle Scholar