Effects of amoxicillin and cefdinir on nasopharyngeal bacterial flora.
OBJECTIVE
To compare the effects of cefdinir (14 mg/kg per day) and amoxicillin (90 mg/kg per day) antimicrobial therapy on the nasopharyngeal flora of children with acute otitis media.


METHODS
Nasopharyngeal cultures for aerobic and facultative bacteria were obtained before therapy and 2 to 4 days after completion of therapy.


METHODS
Outpatient clinic.


METHODS
Fifty children, aged 7 months to 5 years 4 months.


METHODS
After completion of therapy, 22 (88%) of the 25 patients treated with cefdinir and 16 (64%) of the 25 patients treated with amoxicillin were considered clinically cured (P<.05). A significant reduction in the number of all isolates occurred following therapy in those treated with cefdinir (36 vs 71, P<.01) or with amoxicillin (56 vs 73, P<.05). However, the total number of isolates recovered after therapy was significantly lower in those treated with cefdinir (36) compared with those treated with amoxicillin (56) (P<.01).


RESULTS
The recovery of potential pathogenic organisms (eg, Streptococcus pneumoniae, Staphylococcus aureus, beta-hemolytic streptococci, Haemophilus species, and Moraxella catarrhalis), as well as penicillin-resistant bacteria, was lower following completion of therapy in the cefdinir group (6 pathogens, including 5 that were penicillin resistant), compared with the amoxicillin group (27 pathogens, including 16 that were penicillin resistant) (P<.01).


CONCLUSIONS
This study illustrates the greater ability of cefdinir compared with amoxicillin to reduce the number of potential nasopharyngeal pathogens as well as penicillin-resistant bacteria in children with acute otitis media.
Brook
Itzhak
I
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA. ib6@georgetown.edu
Gober
Alan E
AE
D000208:Acute Disease; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects*; D000077525:Cefdinir; D002511:Cephalosporins / Q000627:therapeutic use*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D010034:Otitis Media with Effusion / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002511:Cephalosporins; D000658:Amoxicillin; D000077525:Cefdinir