Effects of amoxicillin and cefdinir on nasopharyngeal bacterial flora.

Author(s): Brook I, Gober AE

Affiliation(s): Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA. ib6@georgetown.edu

Publication date & source: 2005-09, Arch Otolaryngol Head Neck Surg., 131(9):785-7.

Publication type:

OBJECTIVE: To compare the effects of cefdinir (14 mg/kg per day) and amoxicillin (90 mg/kg per day) antimicrobial therapy on the nasopharyngeal flora of children with acute otitis media. DESIGN: Nasopharyngeal cultures for aerobic and facultative bacteria were obtained before therapy and 2 to 4 days after completion of therapy. SETTING: Outpatient clinic. PATIENTS: Fifty children, aged 7 months to 5 years 4 months. MAIN OUTCOME MEASURES: After completion of therapy, 22 (88%) of the 25 patients treated with cefdinir and 16 (64%) of the 25 patients treated with amoxicillin were considered clinically cured (P<.05). A significant reduction in the number of all isolates occurred following therapy in those treated with cefdinir (36 vs 71, P<.01) or with amoxicillin (56 vs 73, P<.05). However, the total number of isolates recovered after therapy was significantly lower in those treated with cefdinir (36) compared with those treated with amoxicillin (56) (P<.01). RESULTS: The recovery of potential pathogenic organisms (eg, Streptococcus pneumoniae, Staphylococcus aureus, beta-hemolytic streptococci, Haemophilus species, and Moraxella catarrhalis), as well as penicillin-resistant bacteria, was lower following completion of therapy in the cefdinir group (6 pathogens, including 5 that were penicillin resistant), compared with the amoxicillin group (27 pathogens, including 16 that were penicillin resistant) (P<.01). CONCLUSION: This study illustrates the greater ability of cefdinir compared with amoxicillin to reduce the number of potential nasopharyngeal pathogens as well as penicillin-resistant bacteria in children with acute otitis media.