title: Comparison of cefaclor and trimethoprim-sulfamethoxazole in the treatment of acute otitis media.
abstract: The efficacy and safety of cefaclor and trimethoprim-sulfamethoxazole (TMP-SMX) were compared in 100 children with acute otitis media assigned to the two treatment groups in a double-blind, randomized fashion. Treatment was for 10 days. Each patient had a diagnostic tympanocentesis before starting therapy. Pathogens were isolated from the middle ear aspirate in 49% of the cases, and organisms considered nonpathogenic were isolated as pure cultures from an additional 19%. Of the 100 patients 4 of 50 in the cefaclor group and 2 of 50 in the TMP-SMX group were considered treatment failures. In three of the four failures with cefaclor, compliance with the first course of therapy could not be ascertained. All six patients showed a good therapeutic response to an additional 10-day course of cefaclor. We conclude that cefaclor and TMP-SMX have essentially equivalent efficacy in the treatment of acute otitis media.
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002433:Cefaclor / Q000627:therapeutic use*; D002506:Cephalexin / Q000031:analogs & derivatives*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004338:Drug Combinations / Q000627:therapeutic use; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000188:drug therapy*; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D013420:Sulfamethoxazole / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D002433:Cefaclor; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D002506:Cephalexin