TABLE 5.
Comparison of in vitro activity of oral antibiotics for S. pneumoniae isolates based on penicillin susceptibility and concentrations achieved in the middle ear
| Antibiotic (reference) | Penicillin susceptible (μg/ml)
|
Penicillin intermediate (μg/ml)
|
Penicillin resistant (μg/ml)
|
Dose | Concn in middle ear (μg/ml) | |||
|---|---|---|---|---|---|---|---|---|
| MIC50 | MIC90 | MIC50 | MIC90 | MIC50 | MIC90 | |||
| Amoxicillin (130) | 0.13 | 0.13 | 0.25 | 2.0 | 2.0 | 4.0 | 15 mg/kg | 5.6 |
| 1 g | 6.2 | |||||||
| 45 mg/kg | 2–8 | |||||||
| Cefaclor (103) | 1.0 | 2.0 | 8.0 | 64 | 64 | 64 | 15–20 mg/kg | 0.5–5.1 |
| Cefixime (71) | 0.25 | 0.5 | 4.0 | 16 | 32 | 64 | 8 mg/kg | 1.3–1.5 |
| Cefpodoxime (43) | 0.13 | 0.13 | 0.5 | 2.0 | 4 | 8 | 4 mg/kg | 0.9 |
| Cefprozil (103) | 0.25 | 0.25 | 1.0 | 8.0 | 16 | 32 | 15 mg/kg | 2.0 |
| Cefuroxime (144) | 0.13 | 0.13 | 0.5 | 4.0 | 4.0 | 8.0 | 15 mg/kg | 1.4 |
| Loracarbef (103) | 1.0 | 2.0 | 8.0 | 64 | 64 | 64 | 15 mg/kg | 3.9 |
| Azithromycin (103) | 0.13 | 0.13 | 0.13 | 8.0 | 1 | 64 | 10 mg/kg | 8.6 |
| 10 mg/kg then 5 mg/kg | 9.4 | |||||||
| Erythromycin (103, 140) | 0.12 | 0.12 | 0.12 | 16 | 0.12 | >16 | 15 mg/kg | 4.5 |
| Clarithromycin (103) | 0.13 | 0.13 | 0.13 | 2.0 | 0.5 | 64 | 7.5 mg/kg | 2.5 |
| Ceftriaxone (68, 78) | 0.06 | 1.0 | 2.0 | 50 mg/kg | 35 | |||
| Trimethoprim-sulfamethoxazole (103, 140) | 0.25 | >4.0 | >4.0 | >4.0 | 4.0 | 4.0 | 4 mg/kg | 1.4–2.0 |