High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media
An increase in the daily dose of amoxicillin from 45 mg/kg to 90 mg/kg was introduced in late 2000 to respond to increasing presence of penicillin-resistant Streptococcus pneumoniae (PRSP) in Acute Otitis Media (AOM) and in other respiratory infections. The basis for this recommendation is a well un...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Manipal College of Medical Sciences, Pokhara
2021-04-01
|
| Series: | Asian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/33541 |
| _version_ | 1818448295779893248 |
|---|---|
| author | Sandeep Lahiry Krunal Dalal Ashwini Pawar Bhavesh Kotak |
| author_facet | Sandeep Lahiry Krunal Dalal Ashwini Pawar Bhavesh Kotak |
| author_sort | Sandeep Lahiry |
| collection | DOAJ |
| description | An increase in the daily dose of amoxicillin from 45 mg/kg to 90 mg/kg was introduced in late 2000 to respond to increasing presence of penicillin-resistant Streptococcus pneumoniae (PRSP) in Acute Otitis Media (AOM) and in other respiratory infections. The basis for this recommendation is a well understood mechanism of resistance among PRSP as well as established safety profile of amoxicillin with known tolerance to high doses. The addition of a standard dose of clavulanic acid provides protection against resistance present in other pathogens involved in AOM and other respiratory infections. A formulation of high dose of amoxicillin with standard dose of clavulanic acid has been developed to meet the increasing needs for efficacy against bacteria with growing antibiotic resistance. While, on the one hand, there is continued empirical use of standard/lower dose of amoxicillin (45 mg/kg/day) or a second- or third-generation cephalosporin in AOM, on the other hand, there is evidence of a rise in intractable cases (relapses or first-line therapy failures). In addition to this, an evolving disease bacteriology and regional variation in antibiotic susceptibility are determinants of clinical outcome in AOM. The current paper discusses the unmet areas and explains rationale behind guideline-directed empirical high-dose amoxicillin supported with clavulanic acid in AOM. |
| first_indexed | 2024-12-14T20:17:15Z |
| format | Article |
| id | doaj.art-5db70fdeeb254303b59203ce58bce82c |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-12-14T20:17:15Z |
| publishDate | 2021-04-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-5db70fdeeb254303b59203ce58bce82c2022-12-21T22:48:50ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762021-04-01124134144https://doi.org/10.3126/ajms.v12i4.33541High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis mediaSandeep Lahiry 0https://orcid.org/0000-0002-6919-0530Krunal Dalal 1https://orcid.org/0000-0001-5189-7469Ashwini Pawar 2https://orcid.org/0000-0003-1884-2399Bhavesh Kotak 3https://orcid.org/0000-0003-0992-1028Medical Advisor (Anti-infectives), GlaxoSmithKline Pharmaceuticals (India) Therapy Area Lead (Anti-infectives), GlaxoSmithKline Pharmaceuticals (India) Head Medical Affairs, GlaxoSmithKline Pharmaceuticals (India) Country Medical Director, GlaxoSmithKline Pharmaceuticals (India) An increase in the daily dose of amoxicillin from 45 mg/kg to 90 mg/kg was introduced in late 2000 to respond to increasing presence of penicillin-resistant Streptococcus pneumoniae (PRSP) in Acute Otitis Media (AOM) and in other respiratory infections. The basis for this recommendation is a well understood mechanism of resistance among PRSP as well as established safety profile of amoxicillin with known tolerance to high doses. The addition of a standard dose of clavulanic acid provides protection against resistance present in other pathogens involved in AOM and other respiratory infections. A formulation of high dose of amoxicillin with standard dose of clavulanic acid has been developed to meet the increasing needs for efficacy against bacteria with growing antibiotic resistance. While, on the one hand, there is continued empirical use of standard/lower dose of amoxicillin (45 mg/kg/day) or a second- or third-generation cephalosporin in AOM, on the other hand, there is evidence of a rise in intractable cases (relapses or first-line therapy failures). In addition to this, an evolving disease bacteriology and regional variation in antibiotic susceptibility are determinants of clinical outcome in AOM. The current paper discusses the unmet areas and explains rationale behind guideline-directed empirical high-dose amoxicillin supported with clavulanic acid in AOM.https://www.nepjol.info/index.php/AJMS/article/view/33541acute otitis mediaamoxicillinamoxicillin/clavulanic acidpenicillin-resistant streptococcus pneumoniae (prsp)otitis proneefficacyrelapse |
| spellingShingle | Sandeep Lahiry Krunal Dalal Ashwini Pawar Bhavesh Kotak High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media Asian Journal of Medical Sciences acute otitis media amoxicillin amoxicillin/clavulanic acid penicillin-resistant streptococcus pneumoniae (prsp) otitis prone efficacy relapse |
| title | High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media |
| title_full | High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media |
| title_fullStr | High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media |
| title_full_unstemmed | High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media |
| title_short | High-Dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media |
| title_sort | high dose amoxicillin supported with clavulanic acid as empirical therapy in acute otitis media |
| topic | acute otitis media amoxicillin amoxicillin/clavulanic acid penicillin-resistant streptococcus pneumoniae (prsp) otitis prone efficacy relapse |
| url | https://www.nepjol.info/index.php/AJMS/article/view/33541 |
| work_keys_str_mv | AT sandeeplahiry highdoseamoxicillinsupportedwithclavulanicacidasempiricaltherapyinacuteotitismedia AT krunaldalal highdoseamoxicillinsupportedwithclavulanicacidasempiricaltherapyinacuteotitismedia AT ashwinipawar highdoseamoxicillinsupportedwithclavulanicacidasempiricaltherapyinacuteotitismedia AT bhaveshkotak highdoseamoxicillinsupportedwithclavulanicacidasempiricaltherapyinacuteotitismedia |