Treatment of Acute Otitis Media of Infancy With Cefaclor

Abstract

\s=b\ The emergence of ampicillin-resistant Haemophilus as a clinical problem in otitis media necessitates a search for alternative, effective therapy. An orally absorbable cephalosporin derivative, cefaclor, is equally effective in vitro against ampicillin-susceptible and -resistant Haemophilus and against other bacteria that cause acute otitis media. Two dosage schedules of cefaclor (40 and 60 mg/ kg/day) were evaluated in 95 infants with acute otitis media. Bacterial origin was determined by a culture of tympanocentesis fluid. Success rates using the smaller dosage were inferior to those using the larger dosage. Results of therapy for pneumococcal and Haemophilus infection with 60 mg/kg/day were comparable to those previously found with amoxicillin trihydrate or with combinations of trisulfapyrimadines with erythromycin or penicillin V. One patient with an ampicillin\x=req-\ resistant Haemophilus infection responded well to cefaclor and did not have a relapse. Cefaclor was well tolerated and caused an acceptably low incidence of minor, adverse effects. Cefaclor deserves further testing as a candidate for preferred status as a single-drug treatment of acute otitis media.

Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications

“…Sulfisoxazole is administered orally as tablets in combination with erythromycin for the treatment of acute otitis media in children. Although various clinical studies have proven this combination to be as effective as other antibiotics given for this indication [56,57], Krause et al showed that amoxicillin-treated patients obtained a superior clinical outcome, thus recommending its use [58]. However, in patients with a history of penicillin hypersensitivity or with ampicillin-resistant Haemophilus influenzae infections, this combination or trimethoprim-sulfamethoxazole (both antifolates too) might be preferred.…”

Evaluation of Cefaclor in Acute Otitis Media Caused by Ampicillin-resistant H. influenzae

“…1,2 There is a paucity of clinical studies evaluating its efficacy in treating acute otitis media due to ampicillin-resistant Hemophilus influenzae. The present study describes our experience using cefaclor in 13 children with acute otitis media caused by ampicillin-resistant H. influenzae.…”

Cefaclor (Ceclor® - Eli Lilly and Company)

“…3e > 39 . 45 Baraff et al administered cefaclor in a variety of doses (13-52 mg/kg/day) to 36 children (ages six months to 17 years) with bacterial respiratory infections, including group A streptococcal tonsilitis (17), scarlet fever ( 7 ) , otitis media (10), and pneumonia ( 2 ) . All isolates were susceptible to less than 3.1 μg/ml, except two cases of H. influenzae which were inhibited by 12.5 /ig/ml.…”