In vivo activity of amoxicillin/clavulanic acid and erythromycin in experimental otitis media caused by Streptococcus pneumoniae plus Haemophilus influenzae

• Published in: International journal of antimicrobial agents Vol. 23; no. 1; pp. 25 - 31
• Main Authors: Parra, Araceli, Ponte, Carmen, Cenjor, Carlos, Garcı́a-Olmos, Marta, Giménez, Marı́a J, Aguilar, Lorenzo, Soriano, Francisco
• Format: Journal Article
• Language: English
• Published: London Elsevier B.V 2004; Amsterdam Elsevier; New York, NY
• Subjects: Acute otitis media; Amoxicillin-Potassium Clavulanate Combination - therapeutic use; Animal model; Animals; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Disease Models, Animal; Drug Therapy, Combination; Erythromycin - therapeutic use; Gerbillinae; H. influenzae; Haemophilus Infections - drug therapy; Haemophilus influenzae; Haemophilus influenzae - drug effects; Haemophilus influenzae - isolation & purification; Medical sciences; Microbial Sensitivity Tests; Otitis Media - drug therapy; Otitis Media - metabolism; Otitis Media - microbiology; Pharmacology. Drug treatments; Pneumococcal Infections - complications; Pneumococcal Infections - drug therapy; Pneumococcal Infections - microbiology; S. pneumoniae; Streptococcus pneumoniae; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - isolation & purification; H. influenzae; Animal model; S. pneumoniae; Acute otitis media; Clavulanic acid; Middle ear disease; β-Lactamase; Haemophilus influenzae; Penicillin derivatives; Bacteria; Micrococcales; ENT disease; Drug combination; Enzyme; β-Lactams; Acute; Rodentia; Enzyme inhibitor; Erythromycin; Macrolide; Streptococcus pneumoniae; Infection; Pasteurellaceae; Streptococcaceae; Antibiotic; Vertebrata; Chemotherapy; Mammalia; Treatment; Animal; Amoxicillin; Bacteriosis; Hydrolases; Otitis media; Antibacterial agent; Gerbil
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2003.05.016

A gerbil model of acute otitis media induced by Streptococcus pneumoniae plus Haemophilus influenzae was used to assess the efficacy of amoxicillin/clavulanic acid (A/C) (1.5/0.3, 2.5/0.5 and 10/2 mg/kg) and erythromycin (2.5, 10, 20 and 50 mg/kg) with or without acetaminophen. The amoxicillin/clavulanic acid MIC was 1/0.5 mg/l for both organisms and the erythromycin MICs were 0.12 and 4 mg/l for S. pneumoniae and H. influenzae, respectively. The organisms were inoculated directly into the middle ear (ME) and antibiotic treatment started 2 h post-inoculation and continued at 8 h intervals for three doses. Acetaminophen was administered at 50 mg/kg. Samples for bacterial counting were obtained from the ME on day 2. Amoxicillin/clavulanic acid peri-MIC concentrations in ME were effective in eradicating both organisms. Despite the inflammation induced by S. pneumoniae, erythromycin did not eradicate H. influenzae at ME concentrations (2.4 mg/l for erythromycin 50 mg/kg) higher than those obtained in humans but lower than the MIC.