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Antimicrobial Agents and Chemotherapy, January 2000, p. 43-50, Vol. 44, No. 1
0066-4804/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Bacteriologic Efficacies of Oral Azithromycin and Oral Cefaclor in Treatment of Acute Otitis Media in Infants and Young Children

Ron Dagan,1,* Eugene Leibovitz,1 Dan M. Fliss,2 Alberto Leiberman,2 Michael R. Jacobs,3 William Craig,4 and Pablo Yagupsky5

Pediatric Infectious Disease Unit1 and Department of Otolaryngology,2 Clinical Microbiology Laboratory,5 Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Pathology, Case Western Reserve University, Cleveland, Ohio3; and Department of Medicine, University of Wisconsin, and Williams S. Middleton Memorial Veterans Hospital, Madison, Wisconsin4

Received 8 February 1999/Returned for modification 25 July 1999/Accepted 4 October 1999

A prospective, open-label, randomized study was conducted in order to determine the bacteriologic efficacies of cefaclor and azithromycin in acute otitis media (AOM). Tympanocentesis was performed on entry into the study and 3 to 4 days after initiation of treatment. Bacteriologic failure after 3 to 4 days of treatment with both drugs occurred in a high proportion of culture-positive patients, especially in those in whom AOM was caused by Haemophilus influenzae (16 of 33 [53%] of those treated with azithromycin and 13 of 34 [52%] of those treated with cefaclor). Although a clear correlation of the persistence of the pathogen with increased MICs of the respective drugs could be demonstrated for Streptococcus pneumoniae, no such correlation was found for H. influenzae. It is proposed that susceptibility breakpoints for H. influenzae should be considerably lower than the current ones for both cefaclor and azithromycin for AOM caused by H. influenzae.

* Corresponding author. Mailing address: Pediatric Infectious Disease Unit, Soroka University Medical Center, P.O. Box 151, Beer-Sheva 84101, Israel. Phone: (972-7) 640 0547. Fax: (972-7) 623 2334. E-mail: rdagan{at}bgumail.bgu.ac.il.

Antimicrobial Agents and Chemotherapy, January 2000, p. 43-50, Vol. 44, No. 1
0066-4804/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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