title: Concentration of cefuroxime in middle ear effusion of children with acute otitis media.
abstract: BACKGROUND
  Antibiotic concentrations in serum and middle ear effusion are important in determining therapeutic success in acute otitis media. For beta-lactams the most relevant pharmacokinetic index for clinical efficacy is the time for which serum concentrations exceed the minimum inhibitory concentration (MIC) of the pathogen, which should be at least 40 to 50% of the dosing interval.
  
  
  METHODS
  In this open, single center study, the concentration of cefuroxime achieved in the serum and middle ear effusion of pediatric acute otitis media patients with purulent effusion was assessed between 2 and 5 h after a single oral dose of 15 mg/kg cefuroxime axetil suspension.
  
  
  RESULTS
  Serum concentrations of cefuroxime ranged from 2.8 to 7.3 microg/ml and were consistent with the results of previous pharmacokinetic study. These results show that serum concentrations of cefuroxime remain above the MIC90 (2.0 microg/ml) for Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis for at least 5 h (42%) of the 12-h dosing interval. Cefuroxime was detected in 14 of 17 (82%) middle ear effusion samples and ranged from 0.2 to 3.6 microg/ml, indicating that cefuroxime penetrates well into the middle ear.
  
  
  CONCLUSIONS
  Cefuroxime is well-absorbed and penetrates well into the middle ear after oral administration of cefuroxime axetil suspension.
authors.affiliation: Medical Clinic, Reykjavik, Iceland.
authors.forename: E
authors.initials: E
authors.lastname: Thoroddsen
authors.forename: C
authors.initials: C
authors.lastname: Marr
authors.forename: C
authors.initials: C
authors.lastname: Efthymiopoulos
authors.forename: H
authors.initials: H
authors.lastname: Thorarinsson
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D002444:Cefuroxime / Q000378:metabolism / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002511:Cephalosporins / Q000378:metabolism / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D010034:Otitis Media with Effusion / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D002511:Cephalosporins; D002444:Cefuroxime