Ear infection - which drug? - antibiotics

Pediatrics for Parents, April, 1989

Ear Infections--Which Drug? Any regular reader of PforP knows how much we discuss ear infections: diagnosis, treatment, sequelae, etc. That's because otitis media is one of the most common reasons children visit the doctor, and many controversies continue to rage about this illness. A recent Canadian study compared the effectiveness of common antibiotics in treating this infection.

Amoxicillin is considered by many to be the standard. Now some strains of bacteria, specifically Hemophilus influenza (not related to the virus that causes "the flu") and Moraxella catarrhalis, are becoming resistant to amoxicillin. Many different antibiotics were tested against these amoxicillin-resistant strains. These include cefaclor (Ceclor), erythromycin-sulfonamide (Pediazole), trimethoprim-sulfamethoxazole (Septra, Bactrim, and others), and amoxicillin-potassium clavulanate (Augmentin). One of the old standbys, trimethoprim-sulfamethoxazole, was found to be as effective as the more expensive newcomers. One unanswered question is whether trimethoprim-sulfamethoxazole should be used as the first line therapy instead of amoxicillin? This study compared the effectiveness and side effects of trimethoprim-sulfamethoxazole and amoxicillin and found no significant differences in the cure rates or side effects profile. And the trimethoprim-sulfamethoxazole is easier to take since a dose is given every 12 hours, compared to every eight for amoxicillin.