Comparison of amoxicillin and azithromycin in the prevention of recurrent acute otitis media

Diego, Juan Albarrán; Prim, M.P.; Alfonso, Carlos; Sastre, Noelia; Rabanal, I.; Gavilán, Juan Carlos Orosco

doi:10.1016/s0165-5876(00)00465-1

Cited by 14 publications

(5 citation statements)

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“…Standard prophylactic antibiotic regimens for PAD are derived largely from data from studies of immunocompetent patients with recurrent upper respiratory infections (35,104). Prophylaxis is usually initiated with amoxicillin (amoxicilline), trimethoprim-sulfamethoxazole, or azithromycin.…”

Section: Prophylactic Antibioticsmentioning

confidence: 99%

Pathogenesis, Diagnosis, and Management of Primary Antibody Deficiencies and Infections

2009

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SUMMARY Primary antibody deficiencies are the most common primary immunodeficiency diseases. They are a heterogeneous group of disorders with various degrees of dysfunctional antibody production resulting from a disruption of B-cell differentiation at different stages. While there has been tremendous recent progress in the understanding of some of these disorders, the etiology remains unknown for the majority of patients. As there is a large spectrum of underlying defects, the age at presentation varies widely, and the clinical manifestations range from an almost complete absence of B cells and serum immunoglobulins to selectively impaired antibody responses to specific antigens with normal total serum immunoglobulin concentrations. However, all of these disorders share an increased susceptibility to infections, affecting predominantly the respiratory tract. A delay of appropriate treatment for some diseases can result in serious complications related to infections, while timely diagnosis and adequate therapy can significantly decrease morbidity and increase life expectancy and quality of life.

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Section: Prophylactic Antibioticsmentioning

confidence: 99%

Pathogenesis, Diagnosis, and Management of Primary Antibody Deficiencies and Infections

2009

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“…However, these regimens are difficult to deliver effectively, 5 particularly to poor families in remote settings. Previous studies have shown that short‐course azithromycin (for 3–5 days), 6 ‐ 9 weekly single‐dose azithromycin prophylaxis for 12 weeks 10 or a single dose of azithromycin 11 , 12 are effective for treating AOM and are less likely than amoxycillin clavulanate to be associated with gastrointestinal side effects 8 …”

mentioning

confidence: 99%

Single‐dose azithromycin versus seven days of amoxycillin in the treatment of acute otitis media in Aboriginal children (AATAAC): a double blind, randomised controlled trial

Morris

Gadil

McCallum

et al. 2010

Medical Journal of Australia

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Objective: To compare the clinical effectiveness of single‐dose azithromycin treatment with 7 days of amoxycillin treatment among Aboriginal children with acute otitis media (AOM) in rural and remote communities in the Northern Territory. Design, setting and participants: Aboriginal children aged 6 months to 6 years living in 16 rural and remote communities were screened for AOM. Those diagnosed with AOM were randomly allocated to receive either azithromycin (30 mg/kg as a single dose) or amoxycillin (50mg/kg/day in two divided doses for a minimum of 7 days). We used a double‐dummy method to ensure blinding. Our study was conducted from 24 March 2003 to 20 July 2005. Main outcome measures: Failure to cure AOM by the end of therapy; nasal carriage of Streptococcus pneumoniae and non‐capsular Haemophilus influenzae (NCHi). Results: We followed 306 of 320 children (96%) allocated to the treatment groups. Single‐dose azithromycin did not reduce (or increase) the risk of clinical failure (50% failure rate [82/165]) compared with amoxycillin (54% failure rate [83/155]) (risk difference [RD], – 4% [95% CI, – 15% to 7%]; P = 0.504). Compared with amoxycillin, azithromycin significantly reduced the proportion of children with nasal carriage of S. pneumoniae (27% v 63%; RD, – 36% [95% CI, – 47% to – 26%]; P < 0.001) and NCHi (55% v 85%; RD, – 30% [95% CI, – 40% to – 21%]; P < 0.001). Nasal carriage of S. pneumoniae with intermediate or full resistance to penicillin was lower (but not significantly so) in the azithromycin group (10% v 16%), but this group had significantly increased carriage of azithromycin‐resistant S. pneumoniae (10% v 3%; RD, 7% [95% CI, 0.1% to 12%]; P = 0.001). Carriage of β‐lactamase‐producing NCHi was about 5% in both groups. Conclusion: Although azithromycin reduced nasal carriage of S. pneumoniae and NCHi, clinical failure was high in both treatment groups. The possibility of weekly azithromycin treatment in children with persistent AOM should be evaluated. Trial registration: Australian Clinical Trials Registry ACTRN 12609000691246.

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“…A comparative study between azithromycin and amoxicillin as prophylactic drugs in recurrent otitis media by Marchisio, Pricipi et al and by Prim et al also came to a similar conclusion. 10,11 Review study by Cheong et al which compares the effects of interventions by prophylactic antibiotics, tympanostomy tube insertion and adenoidectomy concluded that prophylactic antibiotics are effective in reducing otitis media recurrence, recurrence frequency and total recurrence time. 12 There are several studies where a single antibiotic versus placebo control or comparison between antibiotics like amoxicillin, septran, macrolides etc.…”

Section: Discussionmentioning

confidence: 99%

“…1,8,9 Others include pneumococcal vaccines, intranasal fluticasone during viral infection, intranasal H. Influenza vaccine etc. 5,6,11 In these studies the more successful treatment was the use of grommet insertion which reduced the incidence of OME. 13 Though latest studies do not advocate the routine use of antibiotics for treating AOM and as prophylaxis in recurrent AOM, considering the risk outcome ratio and the fact that there are no major adverse effects involved in this treatment, its use may be justified in situations associated with environmental risk factors.…”

Section: Discussionmentioning

confidence: 99%

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A study on the efficacy of prophylactic antibiotics in recurrent acute otitis media

Vijayakumar

Santhi

2019

Int J Otorhinolaryngol Head Neck Surg

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Background: To study the efficacy of broad spectrum antibiotics in the prophylaxis of recurrent acute otitis media.Methods: 86 patients of age group between 2 and 15 years with history of recurrent otitis media were enrolled to study the efficacy of the prophylactic antibiotics used in this condition. The children were treated with amoxicillin or azithromycin during the acute episode. Then they were divided equally into two groups and assigned to receive amoxicillin in one group and azithromycin in the other group at one third the therapeutic dose as prophylaxis for 6 months. The children were evaluated at the end of every month and recurrent episodes if any, was documented. Results: At the end of 6 months it was observed that prophylactic antibiotics were more effective in the younger age group of 2-7 years. Efficacy rates of 87.5% with azithromycin and 77.4% with amoxicillin were noted.Conclusions: As azithromycin is given once a week compared to amoxicillin which is given daily and was found to be equally effective as a prophylactic drug in recurrent acute otitis media with a better compliance, it is a good alternative to amoxicillin as a prophylactic antibiotic. Proper dosage goes a long way in bringing down resistance to the therapeutic agents.

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Comparison of amoxicillin and azithromycin in the prevention of recurrent acute otitis media

Cited by 14 publications

References 14 publications

Pathogenesis, Diagnosis, and Management of Primary Antibody Deficiencies and Infections

Pathogenesis, Diagnosis, and Management of Primary Antibody Deficiencies and Infections

Single‐dose azithromycin versus seven days of amoxycillin in the treatment of acute otitis media in Aboriginal children (AATAAC): a double blind, randomised controlled trial

A study on the efficacy of prophylactic antibiotics in recurrent acute otitis media

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