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- W2061006839 abstract "To the Editors: We read with interest the well-conducted paper of Arguedas et al1 on azithromycin and amoxicillin in children with acute otitis media (AOM). The authors suggest that single dose azithromycin (30 mg/kg) provides effectiveness similar to that of high dose amoxicillin given for 10 days for treatment of pediatric patients with uncomplicated AOM. In an era of great debate about the need of antimicrobial treatment of AOM and on the duration of treatment, data that give evidence of a good clinical and bacteriologic success with a single dose of an antibiotic are particularly attractive both for children's families and for their pediatricians. However, we think that there is a discrepancy between the typology of patients included and the conclusion and that some elucidations are needed. In contrast to his previous paper on single dose azithromycin,2 in this study, Arguedas states that also children with acute perforation (<24 hours) of the eardrum with visible purulent material in the ear canal were considered candidates. Acute perforation of the tympanic membrane is one of the most common complications of AOM, accompanied by acute drainage through the defect, and deserves more therapeutic attention, given that in patients with a ruptured tympanic membrane the standard 10-day antimicrobial treatment duration is more effective than short treatment.3,4 Thus we think that it is improper to define overall the middle ear disease of the studied population as uncomplicated. Moreover no details are provided either on the number of children with otorrhea treated with the 2 regimens or on their clinical outcome. If children with otorrhea treated in the study would have had an outcome as favorable as children with really uncomplicated AOM, then the conclusion, focusing on uncomplicated AOM, would be too strict, because all episodes of AOM might benefit from the simplified treatment. On the contrary, if there was a difference in the outcome of children with otorrhea, this should be underlined, and this population should be kept separated. The provision of details of the subpopulation of children with otorrhea would, we believe, add useful data to aid the transfer of the information from the paper to the everyday pediatric clinical practice. Paola Marchisio, MD Nicola Principi, MD Institute of Pediatrics University of Milan Milan, Italy" @default.
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- W2061006839 date "2005-09-01" @default.
- W2061006839 modified "2023-10-16" @default.
- W2061006839 title "Single Dose Azithromycin for Treatment of Uncomplicated Acute Otitis Media" @default.
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- W2061006839 doi "https://doi.org/10.1097/01.inf.0000178296.55938.c7" @default.
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