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Third-Generation Cephalosporins in the Treatment of Acute Pneumococcal Otitis MediaAn Animal Study
Richard M. Rosenfeld, MD, MPH;
William J. Doyle, PhD;
J. Douglas Swarts, PhD;
James Seroky;
Blas Perez Pinero, MD
Arch Otolaryngol Head Neck Surg. 1992;118(1):49-52.
Abstract
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• There is concern that third-generation cephalosporins may not be effective in the treatment of acute otitis media due to Streptococcus pneumoniae. Using the chinchilla animal model, we compared two third-generation cephalosporins, cefixime (Suprax) and ceftibuten (investigational), with ampicillin and saline controls in an investigatorblinded, randomized trial. Whereas the saline controls performed worse than all other groups, no significant differences were detected among the three antibiotics regarding the time required to sterilize the middle ear cleft, or the prevalence of positive cultures after 10 days of therapy. The statistical power of the comparisons of cefixime and ceftibuten with ampicillin were 98% and 67%, respectively. The results of this in vivo animal study fail to support the contention that the two third-generation cephalosporins investigated are not effective in the treatment of pneumococcal acute otitis media. Caution is advised when extrapolating these results to the general clinical setting.
(Arch Otolaryngol Head Neck Surg. 1992;118:49-52)
Author Affiliations
From the Pittsburgh (Pa) Otitis Media Research Center and the Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh (Pa). Dr Rosenfeld is now with the Children's National Medical Center, Washington, DC.
Footnotes
Accepted for publication June 27, 1991.
Reprint requests to the Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 3705 Fifth Ave, Pittsburgh, PA 15213-2583 (Dr Rosenfeld).
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