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Title: Amoxicillin Remains Treatment of Choice in Children with Middle Ear Infections: Presented at ICAAC

"Amoxicillin Remains Treatment of Choice in Children with Middle Ear Infections: Presented at ICAAC"

By Ed Susman CHICAGO, IL -- September 18, 2003 -- Amoxicillin remains the treatment of choice for recurrent middle ear infections (otitis media), Canadian researchers stated in a presentation here on September 16th at the 43rd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy. Doctors from Montreal Children's Hospital scrutinized the charts of 60,513 children treated between June 1999 and June 2002. They identified 3,811 children (about 6.3% of the total) who fit the criteria for recurrent middle ear infections, having more than e such episodes in a 6-month period or 4 infections within a year "Treatment failure, defined as a new prescription of antibiotic in the month following the episode of otitis media that was studied, occurred in 1,209 or 31.7% of the children with recurrent otitis media," said Caroline Quach, MD, infectious disease division, department of pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada. The percentage of children who remained free of failure 30 days after initial treatment reached 73.8% if they were given either azithromycin or amoxicillin. Clarithromycin was associated with a 68.2% chance of not experiencing treatment failure. The rate was 67.6% in patients who were administered cefprozil, 65.6% in children who received cefaclor. At the bottom of the list was amoxicillin/clavulanate at 52.3%. Dr. Quach noted, however, that the low level of success for amoxicillin/clavulanate might be associated with the severity of disease. "The administrative nature of the database did not allow us to assess the severity of otitis," she explained. "It is very possible that children with the most severe otitis, and therefore having the highest risk of failure, were initially treated with amoxicillin/clavulanic acid, whereas less severe otitis was treated with other antibiotics. That may explain why amoxicillin/clavulanic acid seemed less effective." Side effects often seen with the drug combination may also have skewed the failure rate, she suggested. The findings, however, showed that amoxicillin was still the drug of choice in recurrent otitis media, said Dr. Quach, "in terms of effectiveness, low cost, and excellent safety profile." [Study title: Antibiotic Utilization and Outcomes in the Treatment of Recurrent Acute Otitis Media in Children. Abstract G-460]

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