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February 12, 2024
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Amoxicillin remains effective against ear infections, small study shows

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Key takeaways:

  • Ear infections are the most common reason children are prescribed antibiotics.
  • Amoxicillin remains effective against acute otitis media, a small study found.

Amoxicillin remains effective against acute otitis media, according to the results of a small study published in the Journal of the Pediatric Infectious Diseases Society.

The goals of the study were to determine amoxicillin’s efficacy in treating ear infections and whether its failure rate differs based on the flora in a child’s ear, according to one of the authors.

IDC0224Frost_Graphic_01

“Ear infections are by far the most common reason that children in the U.S. are prescribed antibiotics,” Holly M. Frost, MD, senior director of the Center for Health Systems Research at Denver Health, told Healio. “By the time a child is 5 years old, 80% of them will have had at least one ear infection, and a quarter of them will have had three or more.”

Frost and colleagues enrolled 205 children aged 6 to 35 months with diagnosed ear infections who had been prescribed amoxicillin as treatment into their study.

They collected nasopharyngeal swabs at enrollment and tested them using bacterial culture and RT-PCR tests. Parents were surveyed at 5 days, 14 days, and 30 days after treatment to assess their children’s symptoms, adherence to antibiotics and any adverse events.

By the 5th day, 74.1% of children experienced improvement in their symptoms, 47.3% had symptomatic resolution and 27.3% reported adverse drug events. Conversely, 5.4% experienced treatment failure and 6.8% had a recurrence. In a control group of 149 children who had not taken any amoxicillin before enrollment in the study, 65.8% had one or more beta-lactamase-producing bacteria — more than double the rate of resistance expected by the researchers.

“We had originally thought that that number would be closer to about 30%,” Frost said.

The most reported bacterial ear pathogens were Moraxella catarrhalis (53%), Streptococcus pneumoniae (34.2%), Haemophilus influenzae (20.1%) and Staphylococcus aureus (14.1%).

Frost said her team currently has two clinical trials in the works that are focused on improving the care of children with ear infections.
he goal is really to take what we found for this study ... and directly move it into clinical practice to make sure that kids are getting the best care they can for ear infections,” Frost said.