Treating acute otitis media post-PCV-7: judicious antibiotic therapy.
Acute otitis media (AOM) is treated with antibiotics in the United States, but the changing distribution of bacterial pathogens that cause the disorder can present physicians with several challenges. Most physicians treat AOM empirically, and their treatment choice should target Streptococcus pneumonia, nontypeable Haemophilus influenzae, and Moraxella catarrhalis, as those bacteria are most often isolated in AOM. First-line treatment for new onset AOM remains amoxicillin (80-90 mg/kg/d, divided twice daily). For persistent or recurrent AOM, guidelines recommend high-dose amoxicillin-clavulanate, cefdinir, cefprozil, cefpodoxime, cefuroxime, or ceftriaxone. Improved diagnosis and optimizing the choice of therapy by considering in vitro and in vivo efficacy of the different antibiotics will improve patient outcomes. Improved patient outcomes will result in fewer AOM episodes, decreased antibiotic resistance, and reduced direct and indirect health care costs.
Casey
Janet R
JR
Elmwood Pediatric Group, Rochester, NY 14620, USA. jrcasey@rochester.rr.com
D000158:Acoustic Impedance Tests; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000145:classification / Q000627:therapeutic use*; D017281:Cost of Illness; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D017048:Health Care Costs; D006801:Humans; D008876:Middle Ear Ventilation; D001936:Moraxella catarrhalis / Q000187:drug effects / Q000302:isolation & purification; D010033:Otitis Media / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D022242:Pneumococcal Vaccines; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification; D018074:Vaccines, Conjugate; D001618:beta-Lactamases / Q000187:drug effects
D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate; D001618:beta-Lactamases