Cefaclor v amoxicillin in treatment of acute otitis media
G. S. Giebink, P. B. Batalden, J. N. Russ and C. T. Le
A randomized clinical trial compared cefaclor and amoxicillin for the
treatment of acute otitis media (AOM). Twenty-four (77%) of the 31 examined
patients treated with cefaclor and 25 (83%) of the 30 examined patients
treated with amoxicillin had resolution of signs and symptoms after
completing a ten- to 14-day course of the antibiotic. Patients who had
bilateral AOM, serous or mucoid middle ear effusion, Hemophilus influenzae
cultured from effusion, or more than five previous otitis media episodes,
or who were 3 years of age or younger were more likely to fail treatment.
Hemophilus influenzae isolated from effusion were significantly less
susceptible to cefaclor than amoxicillin, but none of the 12 treatment
failures were caused by antibiotic-resistant infections. Eight (36%) of the
22 patients who recovered after treatment and were reexamined one to three
weeks later experienced recurrent AOM. Ear-specific, as well as
patient-specific, analyses showed no significant differences between
cefaclor and amoxicillin.
