Michael E. Pichichero, MD Janet R. Casey, MD University of Rochester Medical Center, Rochester, NY
Dr Pichichero has received grants/research support from Abbott Laboratories, Aventis, Bristol-Myers Squibb, GlaxoSmithKline, and Johnson & Johnson; he has served as a consultant to Abbott, Aventis, and GlaxoSmithKline. Dr Evans has received grants/research support from Abbott Laboratories, Bristol-Myers Squibb, GlaxoSmithKline, and Johnson & Johnson.
Other classes of antimicrobials are being studied to determine their effectiveness in AOM. Two fluoroquinolones, gatifloxacin and levofloxacin—effective against the pathogens that cause AOM, including resistant S pnuemoniae—have undergone clinical trial evaluation in children as young as 6 months old. Safety concerns about arthropathy and tendonitis described in juvenile animals but not children appear to have been allayed.31
Also being studied is another antimicrobial class—the ketolides, specifically telithromycin. This third-generation macrolide has less propensity to select for macrolide-resistant pathogens, and more potent activity against macrolide- and penicillin-resistant S pneumoniae and against H influenzae than azithromycin or clarithromycin.32 Telithromycin has shown promising results in studies of AOM treatment.
Drug Brand Names
Amoxicillin/clavulanate • Augmentin
Azithromycin • Zithromax
Cefdinir • Omnicef
Cefixime • Suprax
Cefpodoxime • Vantin
Cefprozil • Cefzil
Ceftriaxone • Rocephin
Cefuroxime • Ceftin
Clarithromycin • Biaxin
Erythromycin-sulfisoxazole • Eryzole, Pediazole
Gatifloxacin • Tequin
Levofloxacin • Levaquin
Loracarbef • Lorabid
Telithromycin • Ketek
TMP-SMZ • Bactrim, Cotrim, Septra, Sulfatrim
CORRESPONDING AUTHOR Michael E. Pichichero, MD, University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Avenue, Box 672, Rochester, NY 14642. E-mail: michael_pichichero@urmc.rochester.edu
