CONCENTRATION OF CEFUROXIME IN MIDDLE-EAR EFFUSION OF CHILDREN WITH ACUTE OTITIS-MEDIA

Background. Antibiotic concentrations in serum and middle ear effusion are important in determining therapeutic success in acute otitis medi a. For beta-lactams the most relevant pharmacokinetic index for clinic al efficacy is the time for which serum concentrations exceed the mini mum inhibitory concentration (MIG) of the pathogen, which should be at least 40 to 50% of the dosing interval.Methods. In this open, single center study, the concentration of cefuroxime achieved in the serum an d middle ear effusion of pediatric acute otitis media patients with pu rulent effusion was assessed between 2 and 5 h after a single oral dos e of 15 mg/kg cefuroxime axetil suspension. Results. Serum concentrati ons of cefuroxime ranged from 2.8 to 7.3 mu g/ml and were consistent w ith the results of previous pharmacokinetic study. These results show that serum concentrations of cefuroxime remain above the MIC90 (2.0 mu g/ml) for Streptococcus pneumoniae, Haemophilus influenzae and Moraxe lla catarrhalis for at least 5 h (42%) of the 12-h dosing interval. Ce furoxime was detected in 14 of 17 (82%) middle ear effusion samples an d ranged from 0.2 to 3.6 mu g/ml, indicating that cefuroxime penetrate s well into the middle ear. Conclusions. Cefuroxime is well-absorbed a nd penetrates well into the middle ear after oral administration of ce furoxime axetil suspension.