Acute otitis media: Making sense of recent guidelines on antimicrobial treatment
Several new recommendations could influence treatment choices.
Other classes of antimicrobials are being studied to determine their effectiveness in AOM. Two fluoroquinolones, gatifloxacin and levofloxacin—effective against the pathogens that cause AOM, including resistant S pnuemoniae—have undergone clinical trial evaluation in children as young as 6 months old. Safety concerns about arthropathy and tendonitis described in juvenile animals but not children appear to have been allayed.31
Also being studied is another antimicrobial class—the ketolides, specifically telithromycin. This third-generation macrolide has less propensity to select for macrolide-resistant pathogens, and more potent activity against macrolide- and penicillin-resistant S pneumoniae and against H influenzae than azithromycin or clarithromycin.32 Telithromycin has shown promising results in studies of AOM treatment.
- Amoxicillin/clavulanate • Augmentin
- Azithromycin • Zithromax
- Cefdinir • Omnicef
- Cefixime • Suprax
- Cefpodoxime • Vantin
- Cefprozil • Cefzil
- Ceftriaxone • Rocephin
- Cefuroxime • Ceftin
- Clarithromycin • Biaxin
- Erythromycin-sulfisoxazole • Eryzole, Pediazole
- Gatifloxacin • Tequin
- Levofloxacin • Levaquin
- Loracarbef • Lorabid
- Telithromycin • Ketek
- TMP-SMZ • Bactrim, Cotrim, Septra, Sulfatrim
CORRESPONDING AUTHOR
Michael E. Pichichero, MD, University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Avenue, Box 672, Rochester, NY 14642. E-mail: michael_pichichero@urmc.rochester.edu
