Short-Course Antimicrobial Treatment for Acute Otitis Media

Paradise, Jack L.

doi:10.1001/jama.1997.03550200016006

Cited by 52 publications

(3 citation statements)

References 25 publications

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“…Although most authors favor the use of antibiotics [7,13], there are studies showing no benefits from antibiotic therapy [14,15]. Penicillin-insensitive S. pneumoniae and H. influenzae are increasing worldwide [16,17].…”

mentioning

confidence: 99%

Role ofStreptococcus pneumoniaeandHaemophilus influenzaein the Development of Acute Otitis Media and Otitis Media with Effusion in a Gerbil Model

Soriano¹,

Parra²,

Cenjor

et al. 2000

J INFECT DIS

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The efficacy of amoxicillin/clavulanate and cefuroxime was determined in a gerbil model of otitis media with a mixed Streptococcus pneumoniae plus Haemophilus influenzae middle ear (ME) infection. Results were compared with those obtained in a previous single H. influenzae model. All untreated animals inoculated with the mixed inoculum developed acute otitis media (AOM), whereas 86.7% of those inoculated with H. influenzae developed otitis media with effusion (OME). Antibiotics eradicated H. influenzae from the ME more efficiently in AOM than in OME, and this difference was highly significant (P80% of animals developed culture-negative OME.

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mentioning

confidence: 99%

Role ofStreptococcus pneumoniaeandHaemophilus influenzaein the Development of Acute Otitis Media and Otitis Media with Effusion in a Gerbil Model

Soriano¹,

Parra²,

Cenjor

et al. 2000

J INFECT DIS

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“…The first-choice antibiotic is amoxicillin, 50–60 mg/kg/d in three single doses for 10 days [ 12 ], [ 33 ]. In children older than 6 years with mild to moderate AOM, therapy for 5–7 days is sufficient [ 16 ], [ 34 ]. The advantages of amoxicillin are good effectiveness, high safety slim microbiological spectrum, low rate of adverse effects, low cost, and acceptable taste.…”

Section: Selected Diseases and Therapeutic Optionsmentioning

confidence: 99%

Diseases of the middle ear in childhood

Minovi

Dazert

2014

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 13:Doc11; ISSN 1865-1011

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“…Although controversial, in adults with ventilator-associated pneumonia, a meta-analysis found evidence for increased risk of relapse with shorter antibiotic treatments (OR 1.7; 95% CI 1.0 to 2.8) during the following 4 weeks and all clinical point estimates favoured longer treatment courses 21. Supportive meta-analysis and large RCT data in other bacterial infections (streptococcal tonsillitis,22 otitis media in children aged <2 years23 24 and urinary tract infections25) show higher recurrence, failure and/or poorer bacterial eradication rates with shorter (<7 days) antibiotic courses. Thus, preventing persistent wet cough (indicating presence of infected secretions) and/or recurrent ALRIs or pneumonia after an initial episode of pneumonia could have long-term benefits for lung health in children from groups deemed to be at high-risk of these complications 26…”

Section: Introductionmentioning

confidence: 99%

HOspitalised Pneumonia Extended (HOPE) Study to reduce the long-term effects of childhood pneumonia: protocol for a multicentre, double-blind, parallel, superiority randomised controlled trial

Chang

Fong²,

Yeo

et al. 2019

BMJ Open

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IntroductionEarly childhood pneumonia is a common problem globally with long-term complications that include bronchiectasis and chronic obstructive pulmonary disease. It is biologically plausible that these long-term effects may be minimised in young children at increased risk of such sequelae if any residual lower airway infection and inflammation in their developing lungs can be treated successfully by longer antibiotic courses. In contrast, shortened antibiotic treatments are being promoted because of concerns over inducing antimicrobial resistance. Nevertheless, the optimal treatment duration remains unknown. Outcomes from randomised controlled trials (RCTs) on paediatric pneumonia have focused on short-term (usually <2 weeks) results. Indeed, no long-term RCT-generated outcome data are available currently. We hypothesise that a longer antibiotic course, compared with the standard treatment course, reduces the risk of chronic respiratory symptoms/signs or bronchiectasis 24 months after the original pneumonia episode.Methods and analysisThis multicentre, parallel, double-blind, placebo-controlled randomised trial involving seven hospitals in six cities from three different countries commenced in May 2016. Three-hundred-and-fourteen eligible Australian Indigenous, New Zealand Māori/Pacific and Malaysian children (aged 0.25 to 5 years) hospitalised for community-acquired, chest X-ray (CXR)-proven pneumonia are being recruited. Following intravenous antibiotics and 3 days of amoxicillin-clavulanate, they are randomised (stratified by site and age group, allocation-concealed) to receive either: (i) amoxicillin-clavulanate (80 mg/kg/day (maximum 980 mg of amoxicillin) in two-divided doses or (ii) placebo (equal volume and dosing frequency) for 8 days. Clinical data, nasopharyngeal swab, bloods and CXR are collected. The primary outcome is the proportion of children without chronic respiratory symptom/signs of bronchiectasis at 24 months. The main secondary outcomes are ‘clinical cure’ at 4 weeks, time-to-next respiratory-related hospitalisation and antibiotic resistance of nasopharyngeal respiratory bacteria.Ethics and disseminationThe Human Research Ethics Committees of all the recruiting institutions (Darwin: Northern Territory Department of Health and Menzies School of Health Research; Auckland: Starship Children’s and KidsFirst Hospitals; East Malaysia: Likas Hospital and Sarawak General Hospital; Kuala Lumpur: University of Malaya Research Ethics Committee; and Klang: Malaysian Department of Health) have approved the research protocol version 7 (13 August 2018). The RCT and other results will be submitted for publication.Trial registrationACTRN12616000046404.

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Short-Course Antimicrobial Treatment for Acute Otitis Media

Cited by 52 publications

References 25 publications

Role ofStreptococcus pneumoniaeandHaemophilus influenzaein the Development of Acute Otitis Media and Otitis Media with Effusion in a Gerbil Model

Role ofStreptococcus pneumoniaeandHaemophilus influenzaein the Development of Acute Otitis Media and Otitis Media with Effusion in a Gerbil Model

Diseases of the middle ear in childhood

HOspitalised Pneumonia Extended (HOPE) Study to reduce the long-term effects of childhood pneumonia: protocol for a multicentre, double-blind, parallel, superiority randomised controlled trial

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