Treatment of acute otitis media of infancy with cefaclor
J. D. Nelson, C. M. Ginsburg, J. C. Clahsen and L. H. Jackson
The emergence of ampicillin-resistant Haemophilus as a clinical problem in
otitis media necessitates a search for alternative, effective therapy. An
orally absorbable cephalosporin derivative, cefaclor, is equally effective
in vitro against ampicillin-susceptible and -resistant Haemophilus and
against other bacteria that cause acute otitis media. Two dosage schedules
of cefaclor (40 and 60 mg/kg/day) were evaluated in 95 infants with acute
otitis media. Bacterial origin was determined by a culture of
tympanocentesis fluid. Success rates using the smaller dosage were inferior
to those using the larger dosage. Results of therapy for pneumococcal and
Haemophilus infection with 60 mg/kg/day were comparable to those previously
found with amoxicillin trihydrate or with combinations of
trisulfapyrimadines with erythromycin or penicillin V. One patient with an
ampicillin-resistant Haemophilus infection responded well to cefaclor and
did not have a relapse. Cefaclor was well tolerated and caused an
acceptably low incidence of minor, adverse effects. Cefaclor deserves
further testing as a candidate for preferred status as a single-drug
treatment of acute otitis media.
