erythromycin-estolate and Otitis-Media

A double-blind, randomized trial of four antimicrobial regimens was conducted in 383 infants and children with acute otitis media. The drugs used were penicillin V, amoxicillin trihydrate, erythromycin estolate, and erythromycin estolate with trisulfapyrimidines. Aspiration of middle ear fluid for culture was done before treatment and repeated during treatment if fluid persisted. Etiologic bacteria were most commonly pneumococci (31%) or Haemophilus sp (22%), and an additional 5% of patients had both organisms. Amoxicillin was the most effective in promoting initial response in pneumococcal infection. For Haemophilus infections, the cure rates with amoxicillin and the erythromycin-trisulfapyrimidines mixture were significantly better than with the other two regimens, and serous otitis did not occur during the follow-up period; however, new episodes of otitis were comparable in the four groups. Amoxicillin and the erythromycin estolate-trisulfapyrimidines combination appear to be somewhat more effective than penicillin V or erythromycin estolate.

Topics: Acute Disease; Amoxicillin; Child, Preschool; Clinical Trials as Topic; Ear, Middle; Erythromycin Estolate; Haemophilus; Haemophilus Infections; Humans; Infant; Otitis Media; Penicillin G; Penicillin V; Pyrimidines; Recurrence; Streptococcal Infections; Streptococcus pneumoniae; Streptococcus pyogenes; Sulfonamides; Tympanic Membrane

Cefadroxil monohydrate, an oral cephalosporin with a long half-life, was compared to erythromycin estolate for efficacy in treating upper respiratory tract infections in children. The study was carried out on forty patients, twenty receiving cefadroxil and twenty receiving erythromycin. Each drug was dosed at 50 mg/kg/day and was given every 12 hours in two equally divided doses. The complete cure rate was 95% for the cefadroxil group and 80% for the erythromycin group. Two patients originally in the erythromycin test group showed no improvement either bacteriologically or clinically after 3 days of treatment. It was found that these patients harboured S. aureus which had become resistant to erythromycin during the course of therapy. Both patients were shifted to cefadroxil treatment and achieved complete cures. Two patients in the erythromycin group and one in the cefadroxil group were diagnosed as having scarlet fever. All three responded clinically, yet cultures from the two treated with erythromycin showed persistence of bacteria while the one treated with cefadroxil proved to be cured both clinically and bacteriologically.

Topics: Cefadroxil; Cephalexin; Child; Child, Preschool; Erythromycin; Erythromycin Estolate; Female; Humans; Infant; Male; Otitis Externa; Otitis Media; Respiratory Tract Infections

Topics: Child; Drug Therapy; Erythromycin; Erythromycin Estolate; Haemophilus Infections; Haemophilus influenzae; Humans; Infections; Otitis Media