A prospective observational study of 5-, 7-, and 10-day antibiotic treatment for acute otitis media
A prospective observational study of 5-, 7-, and 10-day antibiotic treatment for acute otitis media
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DOI：
10.1067/mhn.2001.114311
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发表时间：
2001-04-01
影响因子：
3.4
通讯作者：
Green, JL
中科院分区：
文献类型：
--
作者：
Pichichero, ME;Marsocci, SM;Green, JL
目的：比较5天，7天和10天的抗生素治疗急性中耳炎（AOM）在children.Study Design AND SETTTING：前瞻性非随机1年评价3个治疗持续时间AOM在一个私人儿科环境。在治疗开始后14 +/-4天评估结果，临床反应分为治愈、改善或失败。结果：共有2172名儿童接受了研究; 46.4%的儿童小于或等于2岁。使用的抗生素为阿莫西林（61.9%的患者）、甲氧苄啶/磺胺甲恶唑（11.7%）、头孢菌素（14.2%）、阿莫西林/克拉维汀（5.2%）和大环内酯类/氮杂内酯类（4.8%）。比较5天（n = 707）、7天（n = 423）或10天（n = 1042）治疗，包括小于或等于2岁的儿童，未观察到总体结局差异。然而，在前一个月发生过AOM的亚组中，结果不同; 5天治疗后失败的频率高于10天治疗（P < 0.0001），前一个月无AOM结论：我们的研究支持大多数患者的标准AOM抗生素治疗时间从10天过渡到5天。10天方案可能是上级的儿童谁经历了AOM发作在前一个月内，一个已知的危险因素，耐药细菌感染的中耳炎易感患者。
OBJECTIVE: To compare 5-, 7- and 10-day duration of antibiotic therapy for acute otitis media (AOM) in children.STUDY DESIGN AND SETTING: Prospective nonrandomized I-year evaluation of 3 treatment durations for AOM in a private pediatric setting. Outcomes assessed at 14 +/- 4 days after start of therapy with clinical response categorized as cure, improvement, or failure.RESULTS: A total of 2172 children were studied; 46.4% were less than or equal to2-years-old. Antibiotics used were amoxicillin (61.9% of patients), trimethoprim/sulfamethoxazole (11.7%), cephalosporins (14.2%), amoxicillin/clavulanate (5.2%), and macrolides/azalides (4.8%). No overall difference in outcome was observed comparing the 5-day (n = 707), 7-day (n = 423), or 10-day (n = 1042) treatments, including children less than or equal to2-years-old. However, in the subset who had an episode of AOM in the preceding month, outcome differed; 5-day treatment was followed by more frequent failure than 10-day treatment (P 2-years-old (P < 0.0001), no AOM in the preceding month (P = 0.07), or preceding 12 months (P = 0.03).CONCLUSIONS: Our study supports the transition from 10 to 5 days for standard AOM antibiotic treatment duration in most patients. A 10-day regimen may be superior in children who have experienced an episode of AOM within the preceding month, a known risk factor for resistant bacterial infection in the otitis-prone patient.