Short-course cefotaxime compared with five-day co-amoxyclav in acute otitis media in children

Abstract

This randomized, multicentre prospective study was undertaken to compare the efficacy and tolerance of a one day course of injectable cefotaxime with a five day oral course of co-amoxyclav (amoxycillin plus clavulanic acid) in the treatment of acute otitis media in children. The study was conducted in 116 patients between the ages of three months and 12 years. No significant difference in efficacy was observed between the two treatment groups, but tolerance to the treatments differed significantly. There were no unwanted side-effects in the cefotaxime group whereas 22% of children in the amoxycillin plus clavulanic acid group suffered side-effects (P 0.0007). Short-course antibiotic therapy with cefotaxime appears to be a valuable alternative to conventional treatment regimens for acute otitis media in children.

Higher Dosages of Azithromycin Are More Effective in Treatment of Group A Streptococcal Tonsillopharyngitis

“…Shortened-course treatment has been shown to reduce the number of adverse events associated with antibiotic therapy [52,53]. Overall, the trials included in this analysis did not show a difference in the number of adverse events associated with the different treatment courses, and the 2 trials that compared 2 different dosages of azithromycin [22,27] showed no association between an increase in adverse events and a higher dosage.…”

Treatment of Acute Otitis Media With a Shortened Course of Antibiotics

“…Substantial interrater agreement for trial inclusion into the metaanalysis for the remaining trials ( score, 0.89; 95% CI, 0.86-0.92) was attained. Twelve of these trials were excluded from the meta-analysis for the following reasons: duration of antibiotic therapy was equivalent in both treatment arms [34][35][36][37][38][39] ; duration of antibiotic therapy in both treatment arms was either fewer than 7 days 40,41 or 7 days or greater 42 ; there was no comparison of different durations of antibiotic therapy 43 ; trial participants were predominantly adults 44 ; or insufficient data were reported in abstract. 45 This left 32 trials, contained in 29 published reports, for inclusion in the meta-analysis.…”

Efficacy of short course (<4 days) of antibiotics for treatment of acute otitis media in children: A systematic review of randomized controlled trials

“…1). Of the 38 trials satisfying the inclusion criteria, 3 were withdrawn by outcome (34)(35)(36). We therefore finally evaluated 35 trials, which provided 38 analytic components.…”