Single-Dose Ceftriaxone Versus 10 Days of Cefaclor for Otitis Media

Chamberlain, James M.; Boenning, Douglas A.; Waisman, Yehezkel; Ochsenschlager, Daniel W.; Klein, Bruce L.

doi:10.1177/000992289403301101

Cited by 33 publications

(5 citation statements)

References 17 publications

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“…48,59 Concurrent use of a second antibiotic was seen in 1 trial. 61 A check for compliance with antibiotic administration was carried out in half of the trials 26,46,48,[52][53][54][57][58][59]62,67,70,72,73 ; substantial noncompliance was noted in 3 trials in 2 publications, contributing to the withdrawal of patients.…”

Section: Methodologic Qualitymentioning

confidence: 99%

“…Comorbid conditions were a criterion of exclusion, and half of the trials excluded children with chronic or recurrent OM as well. 60,61 The mean age of children in each treatment arm was approximately 2 years and 51.2% of children weremale.Treatmentoutcomecriteriaincluded the resolution of signs and symptoms, with or without persistent effusion, in 3 trials; in the fourth trial a satisfactory outcome was defined as only the resolution of symptoms. 60 Primary outcomes were evaluated at 1 month following the initialassessment,andsecondaryoutcome assessment ranged from 1 to 3 months.…”

Section: Description Of Trialsmentioning

confidence: 99%

“…60,61 The outcomes of treatment with ceftriaxone for 1 month or less and for 3 months or less were not significantly different from those of treatment with a longer course of oral antibiotics, with summary ORs of 1.25 (95% CI, 0.90-1.72) and of 0.91 (95% CI, 0.57-1.47), respectively.…”

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confidence: 95%

See 2 more Smart Citations

Treatment of Acute Otitis Media With a Shortened Course of Antibiotics

Kozyrskyj,

Hildes-Ripstein,

Longstaffe

et al. 1998

JAMA

139

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Section: Methodologic Qualitymentioning

confidence: 99%

Section: Description Of Trialsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Acute Otitis Media With a Shortened Course of Antibiotics

Kozyrskyj,

Hildes-Ripstein,

Longstaffe

et al. 1998

JAMA

139

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“…This study was designed to evaluate the efficacy of ceftriaxone for treatment of AOM in children following clinical failure of oral antibiotic therapy. We used the dosage recommended for childhood infections (50 mg/kg/day), which had previously been found successful in cases of AOM (1,8,9,20,23,29), during a 3-day course of once-daily intramuscular injection defined by a pilot clinical trial performed with a range of doses and with a small number of patients. Among the 173 evaluable patients, (83.8%) were cured.…”

Section: Discussionmentioning

confidence: 99%

Eradication by Ceftriaxone of Streptococcus pneumoniae Isolates with Increased Resistance to Penicillin in Cases of Acute Otitis Media

Géhanno

Nguyen

Barry

et al. 1999

Antimicrob Agents Chemother

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This multicenter, noncomparative, nonrandomized study evaluated the clinical efficacy and safety of ceftriaxone for treating acute otitis media in children following clinical failure of oral antibiotic therapy. Middle-ear fluid samples were collected on day 0 and on day 3, 4, or 5 (day 3 to 5) and were used to test whether ceftriaxone therapy can eradicate Streptococcus pneumoniae isolates with increased resistance to penicillin (MIC ≥ 1 mg/liter). At the first visit, on day 0, middle-ear fluid was sampled for bacteriological testing by tympanocentesis or otorrhea pus suction. Patients were administered 50 mg of ceftriaxone/kg of body weight/day, injected intramuscularly once daily, for 3 days. A second sample was collected by tympanocentesis if a pneumococcus isolate for which the MIC of penicillin was ≥1 mg/liter was detected in the day-0 sample and if the middle-ear effusion persisted on day 3 to 5. This second sample was tested for bacterial eradication. One hundred eighty-six children aged 5 months to 5 years, 10 months, with acute otitis media clinical failure were enrolled and treated in this trial. On day 10 to 12, 145 (83.8%) of the 173 patients evaluable for clinical efficacy were clinically cured. Of the 59 patients infected by pneumococci, 36 had isolates for which the MICs of penicillin were ≥1 mg/liter. Of those patients, on day 10 to 12, 32 (88.9%) were clinically cured. Middle-ear fluid samples collected by day 3 to 5 following the onset of treatment with ceftriaxone were sterile for 24 of the 27 (88.9%) patients who were infected as of day 0 by pneumococci for which the MICs of penicillin were ≥1 mg/liter and who were evaluable for bacteriological eradication. On day 10 to 12, 81.4% of S. pneumoniae-infected children and 87.5% of Haemophilus influenzae-infected children were clinically cured. No discontinuation of treatment due to adverse events, particularly due to local reactions at the injection site, were reported. Only 11 adverse events which had doubtful, probable, or possible links with the study treatment were recorded. Both the bacteriologically assessed eradication of pneumococci for which the MICs of penicillin were ≥1 mg/liter and the clinical cure rates demonstrate that ceftriaxone is of value in the management of acute otitis media unresponsive to previous oral antibiotic therapy.

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“…In addition to short-course therapy, a single intramuscular dose therapy of ceftriaxone has been shown to have benefit equal to that of Ionger courses of amoxicillin (54), cefaclor (55), or trimethoprim-sulfamethoxasole (56) for the treatment of acute suppurative otitis media. Where antibiotic resistance to S. pneumoniae is high or where patient compliance is an issue, ceftriaxone may be a viable alternative.…”

Section: Treatmentmentioning

confidence: 99%

Upper Respiratory Infections and Acute Bronchitis

Mainous¹,

Hueston²

2001

Management of Antimicrobials in Infectious Diseases

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Upper respiratory infections include uncomplicated upper respiratory infections also known as the "common cold," acute otitis media, pharyngitis/tonsillitis, and acute sinusitis. These conditions, along with acute bronchitis, are very common illnesses that are seen often in outpatient settings and are widely treated with antibiotics; in fact, they are the primary indications for outpatient antibiotic prescriptions. These conditions tend to have overlapping clinical characteristics, yet evidence regarding the utility of antimicrobial treatments varies across different infections. UNCOMPLICATED UPPER RESPIRATDRY INFECTION/COMMON COLD Clinical DescriptionUncomplicated upper respiratory infections (URis) are characterized by rhinorrhea, nasal congestion, sneezing, sore or "scratchy" throat, and cough ( 1 ). The incubation period varies between 48 and 72 h. In some cases a low-grade fever is present, but temperature elevation in adults is rare. The early symptoms may be minimal and limited to malaise and nasal symptoms. The nasal discharge is initially clear and watery. There is a subsequent transition period where the nasal discharge becomes viscous, opaque, and discolored (white, yellow, green) (2). The color of the secretions is not predictive of a bacterial infection. The clinical presentation is similar in both adults and children. The episode tends to be self-limited. The median duration of a cold is 1 wk, with most patients improving by the 1Oth day, but lingering symptoms may last up to 2 wk. EpidemiologyURis, or the "common cold," are exactly as the name implies-common. URis are consistently one of the five most common diagnoses in ambulatory physician office visits (3-5). Adults have two to four URis annually and children in day care have as many as six or seven (6, 7). Although URis are mild, self-limited, and of short duration, they are a leading cause of acute morbidity and of industrial and school absenteeism (8). Each year, URis account for 170 million d of restricted activity, 23 million d of school absence, and 18 million d of work absence.

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Single-Dose Ceftriaxone Versus 10 Days of Cefaclor for Otitis Media

Cited by 33 publications

References 17 publications

Treatment of Acute Otitis Media With a Shortened Course of Antibiotics

Treatment of Acute Otitis Media With a Shortened Course of Antibiotics

Eradication by Ceftriaxone of Streptococcus pneumoniae Isolates with Increased Resistance to Penicillin in Cases of Acute Otitis Media

Upper Respiratory Infections and Acute Bronchitis

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