Antibiotic Choices for Ear Infection

Antibiotics are no longer routinely prescribed for acute otitis media. Doctors and parents are giving careful consideration before treating ear infections with antibiotics. Evidence has been building over the years showing most ear infections resolve on their own and antibiotics do little or nothing to speed the process. And overuse of antibiotics leads to antibiotic-resistant strains of bacteria.

Ear infections fall into two major categories: acute otitis media (AOM) and secretory otitis media (otitis media with effusion (OME)). Children with OME have fluid filling the middle ear. Children with AOM have fluid in the middle ear and ear pain. They may have marked redness of the eardrum and distinct bulging of the eardrum, often with fever. These two different conditions call for different treatment.

Antibiotics are effective in most cases of ear infections caused by bacteria. However, only 1 out of 5 children with ear infections needs antibiotics to clear an ear infection. In 4 out of 5 children, ear infections clear on their own. In many countries other than the United States, antibiotics are prescribed much less frequently for ear infections.

Cefuroxime axetil is a semisynthetic, second generation cephalosporin antibiotic.

Cefuroxime axetil is considered a second-line antibiotic choice for the treatment of otitis media, when amoxicillin or amoxicillin/clavulanate are ineffective or cannot be used.

Results of controlled clinical studies in children 3 months to 12 years of age with AOM indicate that a 10-day regimen of oral cefuroxime axetil is as effective or more effective than a 10-day regimen of oral cefaclor, oral amoxicillin, or oral amoxicillin/clavulanate potassium. In published studies, the overall clinical response rate to a 10-day regimen of oral cefuroxime axetil in pediatric patients with AOM has ranged from 62-94%.

Research shows, that short-term course of Cefuroxime axetil (5-day regimen) is effective for the treatment of acute ear infection. In a randomized study in children 3 months to 12 years of age with acute ear infection, a cure or presumed cure was achieved in 92% of those who received a 5-day course of cefuroxime axetil, 84% of those who received a 10-day course or cefuroxime axetil, or 95% of those who received a 10-day course of amoxicillin/clavulanate.

Some doctors caution that short-term antibiotic regimens (i.e., 5 days or less) may not be appropriate for the treatment of ear infections in children younger than 2 years of age or for persons with underlying disease, recurrent or persistent otitis media, or perforated tympanic membranes and spontaneous purulent drainage.