MIDDLE EAR EFFUSION AMOXICILLIN CONCENTRATIONS IN ACUTE OTITIS MEDIA
Amoxicillin is the preferred drug for treatment of acute otitis media (AOM) despite increasing concern about drug-resistant Streptococcus pneumoniae (DRSP). Because of rising MIC values for S. pneumoniae, some recommend higher dosages of amoxicillin to allow middle ear fluid (MEF) to more likely exc...
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| Veröffentlicht in: | The Pediatric infectious disease journal 1998-07, Vol.17 (7), p.657-658 |
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| container_title | The Pediatric infectious disease journal |
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| creator | Harrison, Christopher J Welch, David F |
| description | Amoxicillin is the preferred drug for treatment of acute otitis media (AOM) despite increasing concern about drug-resistant Streptococcus pneumoniae (DRSP). Because of rising MIC values for S. pneumoniae, some recommend higher dosages of amoxicillin to allow middle ear fluid (MEF) to more likely exceed the amount needed to stop growth of DRSP. To have a reasonable chance of efficacy against intermediate and high level resistant DRSP, amoxicillin MEF concentrations should exceed 1.0 mg/l and 2.0 mg/l, respectively. In vivo data are sparse on middle ear concentrations of amoxicillin at higher than standard dosing. After detecting 18% of S. pneumoniae with an MIC for penicillin between 0.1 and 1.0 mg/l (intermediate resistance) in a tympanocentesis investigation, we sought to determine whether 30-mg/kg doses of amoxicillin would provide higher MEF concentrations than the 13-mg/kg doses recommended in the package insert or the 15 mg/kg studied previously. |
| doi_str_mv | 10.1097/00006454-199807000-00019 |
| format | Article |
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Because of rising MIC values for S. pneumoniae, some recommend higher dosages of amoxicillin to allow middle ear fluid (MEF) to more likely exceed the amount needed to stop growth of DRSP. To have a reasonable chance of efficacy against intermediate and high level resistant DRSP, amoxicillin MEF concentrations should exceed 1.0 mg/l and 2.0 mg/l, respectively. In vivo data are sparse on middle ear concentrations of amoxicillin at higher than standard dosing. After detecting 18% of S. pneumoniae with an MIC for penicillin between 0.1 and 1.0 mg/l (intermediate resistance) in a tympanocentesis investigation, we sought to determine whether 30-mg/kg doses of amoxicillin would provide higher MEF concentrations than the 13-mg/kg doses recommended in the package insert or the 15 mg/kg studied previously.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/00006454-199807000-00019</identifier><identifier>PMID: 9686739</identifier><identifier>CODEN: PIDJEV</identifier><language>eng</language><publisher>Baltimore, MD: Williams & Wilkins</publisher><subject>Acute Disease ; Amoxicillin - administration & dosage ; Amoxicillin - pharmacokinetics ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Biological and medical sciences ; Child, Preschool ; Drug Resistance, Microbial ; Ear, Middle ; Exudates and Transudates - metabolism ; Exudates and Transudates - microbiology ; Humans ; Infant ; Medical sciences ; Otitis Media with Effusion - drug therapy ; Otitis Media with Effusion - microbiology ; Penicillins - administration & dosage ; Penicillins - pharmacokinetics ; Pharmacology. Drug treatments ; Streptococcus pneumoniae</subject><ispartof>The Pediatric infectious disease journal, 1998-07, Vol.17 (7), p.657-658</ispartof><rights>Williams & Wilkins 1998. 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Because of rising MIC values for S. pneumoniae, some recommend higher dosages of amoxicillin to allow middle ear fluid (MEF) to more likely exceed the amount needed to stop growth of DRSP. To have a reasonable chance of efficacy against intermediate and high level resistant DRSP, amoxicillin MEF concentrations should exceed 1.0 mg/l and 2.0 mg/l, respectively. In vivo data are sparse on middle ear concentrations of amoxicillin at higher than standard dosing. After detecting 18% of S. pneumoniae with an MIC for penicillin between 0.1 and 1.0 mg/l (intermediate resistance) in a tympanocentesis investigation, we sought to determine whether 30-mg/kg doses of amoxicillin would provide higher MEF concentrations than the 13-mg/kg doses recommended in the package insert or the 15 mg/kg studied previously.</description><subject>Acute Disease</subject><subject>Amoxicillin - administration & dosage</subject><subject>Amoxicillin - pharmacokinetics</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Biological and medical sciences</subject><subject>Child, Preschool</subject><subject>Drug Resistance, Microbial</subject><subject>Ear, Middle</subject><subject>Exudates and Transudates - metabolism</subject><subject>Exudates and Transudates - microbiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Medical sciences</subject><subject>Otitis Media with Effusion - drug therapy</subject><subject>Otitis Media with Effusion - microbiology</subject><subject>Penicillins - administration & dosage</subject><subject>Penicillins - pharmacokinetics</subject><subject>Pharmacology. Drug treatments</subject><subject>Streptococcus pneumoniae</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFPwyAYhonRzDn9CSY9GG9VKIXCsek6JenaZOsSb4RRyKbdpmXL4r8X3dzNSEIIvM_3ER4ACBB8QJAnj9APGpM4RJwzmPhd6CfiZ6CPCI5CyFlyDvqQcRRiStkluHLu1SM4RrAHepwymmDeB8OxGA6LPMjTSZCPRrOpqMogHVcvIhNFIcogq8osL-tJWvtkGviTNJvVeVDVohbTYJwPRXoNLqxqnbk5rgMwG-V19hwW1ZPI0iLUMSU8VNxS1SQwahBXlhhiNEkazQxTczjHSjOiFWows9BYbG1E5jAiGmmqCI0NwwNwf-j73m0-dsZt5WrptGlbtTabnZPMv48wnvwLIkpIEhHsQXYAdbdxrjNWvnfLleo-JYLy27T8NS1PpuWPaV96e7xjN1-Z5lR4VOvzu2OunFat7dRaL90Ji3AcUwY9Fh-w_abdms69tbu96eTCqHa7kH_9M_4CMAuOyg</recordid><startdate>199807</startdate><enddate>199807</enddate><creator>Harrison, Christopher J</creator><creator>Welch, David F</creator><general>Williams & Wilkins</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>199807</creationdate><title>MIDDLE EAR EFFUSION AMOXICILLIN CONCENTRATIONS IN ACUTE OTITIS MEDIA</title><author>Harrison, Christopher J ; Welch, David F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4659-a9f6ad702d19af5e5ec57dc8e8ab0b3ac85ca1d38f0ef3ff25b025c1c6a564e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Acute Disease</topic><topic>Amoxicillin - administration & dosage</topic><topic>Amoxicillin - pharmacokinetics</topic><topic>Antibacterial agents</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Biological and medical sciences</topic><topic>Child, Preschool</topic><topic>Drug Resistance, Microbial</topic><topic>Ear, Middle</topic><topic>Exudates and Transudates - metabolism</topic><topic>Exudates and Transudates - microbiology</topic><topic>Humans</topic><topic>Infant</topic><topic>Medical sciences</topic><topic>Otitis Media with Effusion - drug therapy</topic><topic>Otitis Media with Effusion - microbiology</topic><topic>Penicillins - administration & dosage</topic><topic>Penicillins - pharmacokinetics</topic><topic>Pharmacology. Drug treatments</topic><topic>Streptococcus pneumoniae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harrison, Christopher J</creatorcontrib><creatorcontrib>Welch, David F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harrison, Christopher J</au><au>Welch, David F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MIDDLE EAR EFFUSION AMOXICILLIN CONCENTRATIONS IN ACUTE OTITIS MEDIA</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>1998-07</date><risdate>1998</risdate><volume>17</volume><issue>7</issue><spage>657</spage><epage>658</epage><pages>657-658</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><coden>PIDJEV</coden><abstract>Amoxicillin is the preferred drug for treatment of acute otitis media (AOM) despite increasing concern about drug-resistant Streptococcus pneumoniae (DRSP). Because of rising MIC values for S. pneumoniae, some recommend higher dosages of amoxicillin to allow middle ear fluid (MEF) to more likely exceed the amount needed to stop growth of DRSP. To have a reasonable chance of efficacy against intermediate and high level resistant DRSP, amoxicillin MEF concentrations should exceed 1.0 mg/l and 2.0 mg/l, respectively. In vivo data are sparse on middle ear concentrations of amoxicillin at higher than standard dosing. After detecting 18% of S. pneumoniae with an MIC for penicillin between 0.1 and 1.0 mg/l (intermediate resistance) in a tympanocentesis investigation, we sought to determine whether 30-mg/kg doses of amoxicillin would provide higher MEF concentrations than the 13-mg/kg doses recommended in the package insert or the 15 mg/kg studied previously.</abstract><cop>Baltimore, MD</cop><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>Williams & Wilkins</pub><pmid>9686739</pmid><doi>10.1097/00006454-199807000-00019</doi><tpages>2</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0891-3668 |
| ispartof | The Pediatric infectious disease journal, 1998-07, Vol.17 (7), p.657-658 |
| issn | 0891-3668 1532-0987 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Acute Disease Amoxicillin - administration & dosage Amoxicillin - pharmacokinetics Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Child, Preschool Drug Resistance, Microbial Ear, Middle Exudates and Transudates - metabolism Exudates and Transudates - microbiology Humans Infant Medical sciences Otitis Media with Effusion - drug therapy Otitis Media with Effusion - microbiology Penicillins - administration & dosage Penicillins - pharmacokinetics Pharmacology. Drug treatments Streptococcus pneumoniae |
| title | MIDDLE EAR EFFUSION AMOXICILLIN CONCENTRATIONS IN ACUTE OTITIS MEDIA |
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