Greater likelihood of clinical failure, higher symptom score for five-day course of amoxicillin-clavulanate
THURSDAY, Dec. 22, 2016 (HealthDay News) — Reduced-duration antimicrobial treatment is associated with less favorable outcomes among infants with acute otitis media, according to a study published in the Dec. 22 issue of the New England Journal of Medicine.
Alejandro Hoberman, M.D., from the University of Pittsburgh School of Medicine, and colleagues assigned 520 children aged 6 to 23 months with acute otitis media to receive amoxicillin-clavulanate for 10 days (standard duration) or for a reduced duration of five days followed by five days of placebo.
The researchers found that, compared with children who were treated for 10 days, children treated with amoxicillin-clavulanate for five days were more likely to have clinical failure (34 versus 16 percent). Over the period from day six to day 14, the mean symptom scores were 1.61 and 1.34 in the five- and 10-days groups, respectively (P = 0.07); at the day 12 to 14 assessment, the mean scores were 1.89 versus 1.20 (P = 0.001). The five-day group had a lower percentage of children whose symptom scores decreased more than 50 percent from baseline to the end of treatment (80 versus 91 percent; P = 0.003). No significant differences were seen between the groups in the rates of recurrence, adverse events, or nasopharyngeal colonization with penicillin-nonsusceptible pathogens.
“Among children 6 to 23 months of age with acute otitis media, reduced-duration antimicrobial treatment resulted in less favorable outcomes than standard-duration treatment,” the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry; one author disclosed patents related to the study topic.
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