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Levofloxacin Effective for Middle Ear Infection in Children
The fluoroquinolone levofloxacin is highly effective against bacterial pathogens associated with acute otitis media in children, according to researchers.
In the December issue of the Pediatric Infectious Disease Journal, Dr. Adriano Arguedas of Instituto de Atencion Pediatrica, San Jose, Costa Rica and colleagues, note that levofloxacin has an excellent record in dealing with respiratory pathogens.
To determine its efficacy and safety in acute otitis media, the researchers studied 205 children with, or at high risk for persistent or recurrent disease. They ranged in age from 6 months to 4 years.
In this open-label study, the children underwent tympanocentesis before and 3 to 5 days after receiving levofloxacin 10 mg/kg twice daily. Levofloxacin treatment was continued for 10 days.
Pathogens recovered from cultures of middle ear fluid were Streptococcus pneumoniae, S. pyogenes, Haemophilus influenzae and Moraxella catarrhalis. All isolates were susceptible to levofloxacin.
Bacteria were eradicated from the middle ear fluid of 88% of evaluable children during treatment, including 31 of 37 of those infected with S. pneumoniae and all 54 who had H. influenzae infection.
The clinical success rate was 92% in bacteriologically evaluable children and 94% overall.
Treatment limiting side effects were seen in only 6% of the children. The most common was vomiting, which affected 4% of the participants. The researchers call for larger comparative trials, but, in light of these findings conclude that levofloxacin is safe and effective in treatment of acute otitis media in such patients.