Amoxicillin Versus Other Antibiotic Agents for the Treatment of Acute Otitis Media in Children.
Amoxicillin Versus Other Antibiotic Agents for the Treatment of Acute Otitis Media in Children.
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DOI：
10.1016/j.jpeds.2022.07.053
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发表时间：
2022-12
影响因子：
5.1
通讯作者：
Tsay, Sharon, V
中科院分区：
文献类型：
--
作者：
Frost, Holly M.;Bizune, Destani;Gerber, Jeffrey S.;Hersh, Adam L.;Hicks, Lauri A.;Tsay, Sharon, V
本研究的目的是比较两种抗生素（阿莫西林、阿莫西林-克拉维酸、头孢地尼和阿奇霉素）治疗无并发症的急性中耳炎（AOM）儿童的抗生素治疗失败率和复发率。我们完成了一项回顾性队列研究的儿童6个月至12岁的无并发症AOM确定在全国索赔数据库。主要暴露是抗生素，主要结局是治疗失败和复发。使用逻辑回归估计OR，并按主要暴露、患者年龄和抗生素使用时间进行分层分析。在纳入分析的1 051 007名儿童中，56.6%的儿童处方了阿莫西林，13.5%的儿童处方了阿莫西林-克拉维酸，20.6%的儿童处方了头孢地尼，9.3%的儿童处方了阿奇霉素。大多数处方（93%）为10天，98%在医疗接触后1天内完成。治疗失败和复发的发生率分别为2.2%（95% CI：2.1，2.2）和3.3%（3.2，3.3）。所有药物的联合失败率和复发率均较低，包括阿莫西林（1.7%; 1.7，1.8）、阿莫西林-克拉维酸（11.3%; 11.1，11.5）、头孢地尼（10.0%; 9.8，10.1）和阿奇霉素（9.8%; 9.6，10.0）。尽管AOM病因的微生物学变化，但所有抗生素治疗失败和复发均不常见，阿莫西林治疗失败和复发率低于其他药物。这些发现支持在抗生素处方时继续使用阿莫西林作为AOM的一线药物。（J Pediatr 2022;251：98-104）。
The objective of the study was to compare the antibiotic treatment failure and recurrence rates between antibiotic agents (amoxicillin, amoxicillin-clavulanate, cefdinir, and azithromycin) for children with uncomplicated acute otitis media (AOM). We completed a retrospective cohort study of children 6 months-12 years of age with uncomplicated AOM identified in a nationwide claims database. The primary exposure was the antibiotic agent, and the primary outcomes were treatment failure and recurrence. Logistic regression was used to estimate ORs, and analyses were stratified by primary exposure, patient age, and antibiotic duration. Among the 1 051 007 children included in the analysis, 56.6% were prescribed amoxicillin, 13.5% were prescribed amoxicillin-clavulanate, 20.6% were prescribed cefdinir, and 9.3% were prescribed azithromycin. Most prescriptions (93%) were for 10 days, and 98% were filled within 1 day of the medical encounter. Treatment failure and recurrence occurred in 2.2% (95% CI: 2.1, 2.2) and 3.3% (3.2, 3.3) of children, respectively. Combined failure and recurrence rates were low for all agents including amoxicillin (1.7%; 1.7, 1.8), amoxicillin-clavulanate (11.3%; 11.1, 11.5), cefdinir (10.0%; 9.8, 10.1), and azithromycin (9.8%; 9.6, 10.0). Despite microbiologic changes in AOM etiology, treatment failure and recurrence were uncommon for all antibiotic agents and were lower for amoxicillin than for other agents. These findings support the continued use of amoxicillin as a first-line agent for AOM when antibiotics are prescribed. (J Pediatr 2022;251:98-104).
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影响因子：
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通讯作者：
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