Inhaled tobramycin in children with acute bacterial rhinopharyngitis.
Antibiotic abuse for treating rhinopharyngitis induces the occurrence of resistant bacteria. As topical drugs might reduce this phenomenon, the aims of our study were to evaluate inhaled tobramycin in children with acute bacterial rhinopharyngitis and to compare it with oral amoxicillin/clavulanate. The trial was conducted as randomized, parallel group and double blind. Children, aged 3-6 years, with acute bacterial rhinopharyngitis were treated with 15 mg of aerosolized tobramycin (Group A) or 50 mg/Kg of amoxicillin/clavulanate (Group B) twice daily for 10 days. The following parameters were assessed: nasal obstruction, mucopurulent rhinorrhea, post-nasal drip, adenoidal hypertrophy, tympanic inflammation, tympanogram, rhinomanometry and cultures. Of 416 patients screened, 311 children (178 females and 133 males), median age 4.5 years, completed the study: 156 in Group A and 155 in Group B. Both treatments improved all parameters (p<0.01 for all). Intergroup analysis showed that inhaled tobramycin induced a better improvement versus amoxicillin/clavulanate concerning nasal obstruction (p<0.05), adenoidal hypertrophy (p<0.01), tympanic inflammation (p<0.01), rhinomanometry (p<0.01) and cultures (p<0.05). In conclusion, inhaled tobramycin may represent a valid treatment for acute bacterial rhinopharyngitis in children, as it is effective, safe, economic and simple to use.
Dipartimento Universitario di Patologia della Testa e del Collo, del Cavo Orale e della Comunicazione Audio-Verbale, Seconda Università degli Studi di Napoli, Naples, Italy.
A
A
Varricchio
D
D
Tricarico
A
A
De Lucia
R
R
Utili
M-F
MF
Tripodi
M
M
Miraglia Del Giudice
M
M
Capasso
G
G
Sabatino
M
M
Sgarrella
G L
GL
Marseglia
G
G
Ciprandi
D000208:Acute Disease; D000234:Adenoids / Q000473:pathology; D000280:Administration, Inhalation; D000403:Airway Resistance; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008365:Manometry; D015508:Nasal Obstruction / Q000188:drug therapy; D010612:Pharyngitis / Q000188:drug therapy* / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D014031:Tobramycin / Q000008:administration & dosage / Q000627:therapeutic use*; D014432:Tympanic Membrane / Q000473:pathology
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination; D014031:Tobramycin