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Journal of Antimicrobial Chemotherapy (1999) 44, 85-90
© 1999 The British Society for Antimicrobial Chemotherapy

Antimicrobial treatment of an experimental otitis media caused by a ß-lactamase positive isolate of Haemophilus influenzae

Carmen Pontea, Carlos Cenjorb, Araceli Parraa, Eva Nietoa, Gloria García-Calvoa, María José Giménezc, Lorenzo Aguilarc and Francisco Sorianoa,*

a Department of Medical Microbiology; b Department of Otolaryngology, Fundación Jiménez Díaz, Avenida de Reyes Católicos 2, 28040 Madrid; c Medical Department, SmithKline Beecham Pharmaceuticals, Madrid, Spain

A gerbil model of otitis media induced by a ß-lactamase producing and non-serotypeable isolate of Haemophilus influenzae was used to assess the in-vivo efficacy of co-amoxiclav and cefuroxime at low (5 mg/kg) and high (20 mg/kg) doses. The MIC of the antibiotics tested against the pathogen was 1 mg/L (1/0.5 mg/L for co-amoxiclav). The organism was inoculated (±10 6 cfu) by transbullar challenge directly in the middle ear and antibiotic treatment was commenced 2 h post-inoculation and continued at 8 h intervals for three doses. Only high dose co-amoxiclav significantly reduced the number of culture-positive specimens as compared with untreated animals or with other treatment groups (91.7% as compared with 36.7% for high dose cefuroxime). The results obtained in any treatment group were related to middle ear antibiotic level/MIC. Antibiotic concentrations in the middle ear 90 min after administration were about 10% of serum levels at 15 min, probably related to a slight inflammatory response. Only after high dose co-amoxiclav did the concentration in the middle ear exceed the MIC by a factor of four. In otitis media with effusion, if indicated, antibiotics active in vitro should be administered in high doses and, to avoid side effects, probably in short courses.

* Tel: +33-1-45593219; Fax: +33-1-45593834; E-mail: olivier.mimoz{at}pbr.ap-hop-paris.fr


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A. Parra, C. Ponte, C. Cenjor, C. Martinez-Marin, and F. Soriano
Effect of Antibiotic Treatment Delay on Therapeutic Outcome of Experimental Acute Otitis Media Caused by Streptococcus pneumoniae Strains with Different Susceptibilities to Amoxicillin
Antimicrob. Agents Chemother., March 1, 2004; 48(3): 860 - 866.
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