Information de reference pour ce titreAccession Number: | 00006454-200603000-00008.
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Author: | Arguedas, Adriano MD *; Dagan, Ron MD +; Leibovitz, Eugene MD +; Hoberman, Alejandro MD ++; Pichichero, Michael MD [S]; Paris, Maria MD [//]
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Institution: | From *Instituto de Atencion Pediatrica, Neeman-ICIC, Hospital Nacional de Ninos, San Jose, Costa Rica; the +Pediatric Infectious Disease Unit, Soroka University Medical Center, and the Faculty of Health Sciences, Ben Gurion University of the Negev; Beer Sheva, Israel; the ++Children's Hospital of Pittsburgh, Pittsburgh, PA; the [S]University of Rochester Medical Center, Rochester, NY; and [//]Abbott Laboratories, Abbott Park, IL.
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Title: | |
Source: | Pediatric Infectious Disease Journal. 25(3):211-218, March 2006.
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Abstract: | Background: Given the relatively high prevalence of recurrent and persistent acute otitis media (AOM) and the prominent etiologic role of Streptococcus pneumoniae, especially penicillin-nonsusceptible strains in children with these conditions, new alternative treatments are desirable.
Methods: Children 6 months-4 years of age with AOM considered to be at risk for recurrent or persistent infection received large dosage cefdinir 25 mg/kg oral suspension once daily for 10 days. Children were evaluated pretreatment (day 1), on therapy (days 4-6), end of therapy (days 12-14) and at follow-up (days 25-28). All children had tympanocentesis at enrollment. In culture-positive children, tympanocentesis was repeated after 3-5 days (days 4-6) unless evidence of absence of middle ear effusion was documented.
Results: Of 447 children enrolled, 230 were clinically and bacteriologically evaluable (74% 2 years old or younger; 57% treated for AOM in previous 3 months). Bacteriologic eradication, based on repeat tympanocentesis on days 4-6, was achieved in 74% (170 of 230) of children; 76% (201 of 266) of AOM pathogens were eradicated. Eradication of penicillin-susceptible, -intermediate and -resistant S. pneumoniae was 91% (50 of 55), 67% (18 of 27) and 43% (10 of 23), respectively (P < 0.001); eradication of H. influenzae was 72% (90 of 125). Overall clinical response at days 12-14 was 83% (76 and 82% for children with S. pneumoniae and Haemophilus influenzae, respectively). Sustained clinical response at days 25-28 was 85%. Clinical response was 83% for culture-positive children versus 96% for culture-negative children at baseline tympanocentesis (P < 0.001).
Conclusions: In this study of AOM among children at risk for persistent or recurrent infection, large dose cefdinir resulted in an overall successful clinical response at end of treatment of 83%. This regimen was efficacious against penicillin-susceptible S. pneumoniae, but effectiveness was markedly decreased against nonsusceptible strains and was moderate for H. influenzae strains.
(C) 2006 Lippincott Williams & Wilkins, Inc.
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Author Keywords: | cefdinir; otitis media; recurrent; persistent.
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References: | 1. Klein JO. Otitis media. Clin Infect Dis. 1994;19:823-833.
2. Block SL, Harrison CJ, Hedrick J, Tyler R, Smith A, Hedrick R. Restricted use of antibiotic prophylaxis for recurrent acute otitis media in the era of penicillin non-susceptible Streptococcus pneumoniae. Int J Pediatr Otorhinolaryngol. 2001;61:47-60.
3. Daly KA, Brown JE, Lindgren BR, Meland MH, Le CT, Giebink GS. Epidemiology of otitis media onset by six months of age. Pediatrics. 1999;103(6, pt 1):1158-1166.
4. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989;160:83-94.
5. Auinger P, Lanphear BP, Kalkwarf HJ, Mansour ME. Trends in otitis media among children in the United States. Pediatrics. 2003;112:514-520.
6. Lanphear BP, Byrd RS, Auinger P, Hall CB. Increasing prevalence of recurrent otitis media among children in the United States. Pediatrics. 1997;99:e1-e7. Available at: http//www.pediatrics.org/cgi/content/full/99/3/e1. Accessed January 25, 2005.
7. Pichichero ME. Recurrent and persistent otitis media. Pediatr Infect Dis J. 2000;19:911-916.
8. Arguedas A, Dagan R, Soley C, et al. Microbiology of otitis media in Costa Rican children, 1999 through 2001. Pediatr Infect Dis J. 2003;22:1063-1068.
9. Leibovitz E, Jacobs MR, Dagan R. Haemophilus influenzae: a significant pathogen in acute otitis media. Pediatr Infect Dis J. 2004;23:1142-1152.
10. Pichichero ME, McLinn S, Aronovitz G, et al. Cefprozil treatment of persistent and recurrent acute otitis media. Pediatr Infect Dis J. 1997;16:471-478.
11. Gehanno P, N'Guyen L, Derriennic M, Pichon F, Goehrs JM, Berche P. Pathogens isolated during treatment failures in otitis. Pediatr Infect Dis J. 1998;17:885-890.
12. Dagan R, Hoberman A, Johnson C, et al. Bacteriologic and clinical efficacy of high dose amoxicillin/clavulanate in children with acute otitis media. Pediatr Infect Dis J. 2001;20:829-837.
13. Arrieta A, Arguedas A, Fernandez P, et al. High-dose azithromycin versus high-dose amoxicillin-clavulanate for treatment of children with recurrent or persistent acute otitis media. Antimicrob Agents Chemother. 2003;47:3179-3186.
14. Brook I, Gober AE. Antimicrobial resistance in the nasopharyngeal flora of children with acute otitis media and otitis media recurring after amoxicillin therapy. J Med Microbiol. 2005;54(pt 1):83-85.
15. Guay DRP. Pharmacodynamics and pharmacokinetics of cefdinir, an oral extended spectrum cephalosporin. Pediatr Infect Dis J. 2000;19:S141-S146.
16. Sader HS, Fritsche TR, Mutnick AH, Jones RN. Contemporary evaluation of the in vitro activity and spectrum of cefdinir compared with other orally administered antimicrobials tested against common respiratory tract pathogens (2000-2002). Diag Microbiol Infect Dis. 2003;47:515-625.
17. Adler M, McDonal PJ, Trostmann U, Keyserling CH, Tack K. The Cefdinir Otitis Media Study Group. Comparative safety and efficacy of cefdinir vs. amoxicillin/clavulanate for treatment of suppurative in children. Pediatr Infect Dis J. 2000;19:S166-S170.
18. Block SL, Hedrick JA, Kratzer J, Nemeth MA, Tack KJ. Five-day twice daily cefdinir therapy for acute otitis media: microbiologic and clinical efficacy. 2000;19(suppl):S153-S158.
19. Block S, McCarty JM, Hedrick JA, Nemeth MA, Keyserling CH, Tack K. The Cefdinir Otitis Media Study Group. Comparative safety and efficacy of cefdinir vs. amoxicillin/clavulanate for treatment of suppurative acute otitis media in children. Pediatr Infect Dis J. 2000;19(suppl):S159-S165.
20. Block S, Kratzer J, Nemeth MA, Tack K. Five-day cefdinir course vs. ten-day cefprozil course for treatment of acute otitis media. Pediatr Infect Dis J. 2000;19:S147-S152.
21. Block SL, Busman TA, Paris MM, Bukofzer S. Comparison of five-day cefdinir treatment with ten-day low dose amoxicillin/clavulanate treatment for acute otitis media. Pediatr Infect Dis J. 2004;23:834-838.
22. Block SL, Cifaldi M, Gu Y, Paris MM. A comparison of five days of therapy with cefdinir or azithromycin in children with acute otitis media: a multicenter, prospective, single-blind study. Clin Ther. 2005;27:786-794.
23. National Committee for Clinical Laboratory Standards. Performance standard for dilution antimicrobial susceptibility tests. Approved standard, M7-A45. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000.
24. National Committee for Clinical Laboratory Standards. Performance standard for dilution antimicrobial susceptibility testing: 12th informational supplement, M-100-S12. Wayne, PA: National Committee for Clinical Laboratory Standards; 2002.
25. National Committee for Clinical Laboratory Standards. Performance standard for dilution antimicrobial susceptibility testing: 12th informational supplement, M-100-S12. Wayne, PA: National Committee for Clinical Laboratory Standards; 2002.
26. Omnicef(R) Prescribing Information, Abbott Laboratories, c. 2004.
27. American Academy of Pediatrics. Clinical practice guidelines: diagnosis and management of acute otitis media. Pediatrics. 2004;113:1451-1465.
28. Casey JR, Pichichero ME. Changes in frequency and pathogens causing acute otitis media in 1995-2003. Pediatr Infect Dis J. 2004;23:824-828.
29. Leibovitz E, Piglansky L, Raiz S, Press J, Leiberman A, Dagan R. Bacteriologic and clinical efficacy of one day vs. three day intramuscular ceftriaxone for treatment of nonresponsive acute otitis media in children. Pediatr Infect Dis J. 2000;19:1040-1045.
30. Bowlware KL, McCracken GH Jr, Hernandez LJ, Ghaffar F. Cefdinir pharmacokinetics and tolerability in children receiving 25 mg/kg once daily. Pediatr Infect Dis J. 2006;25:208-210.
31. Leibovitz E, Greenberg D, Piglansky L, et al. Recurrent acute otitis media occurring within one month from completion of antibiotic therapy relationship to the original pathogen. Pediatr Infect Dis J. 2003;22:209-215.
32. Arguedas A, Emparanza P, Schwartz RH, et al. A randomized, multicenter, double blind, double dummy trial of single dose azithromycin versus high dose amoxicillin for treatment of uncomplicated acute otitis media. Pediatr Infect Dis J. 2005;24:153-161.
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Language: | English.
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Document Type: | Original Studies.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0891-3668
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NLM Journal Code: | oxj, 8701858
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DOI Number: | https://dx.doi.org/10.1097/01.in...- ouverture dans une nouvelle fenêtre
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