Stutman H R, Arguedas A G
Department of Pediatrics, Memorial Miller Children's Hospital, Long Beach, California 90801-1428.
Clin Infect Dis. 1992 Jun;14 Suppl 2:S204-8; discussion S209-11. doi: 10.1093/clinids/14.supplement_2.s204.
In two randomized clinical trials in children with otitis media, the efficacy and safety of cefprozil are compared to those of amoxicillin/clavulanate (n = 530) and of cefaclor and cefixime (n = 394). The rate of clinical cure or improvement was similar among patients receiving each drug regimen, ranging from 78% for amoxicillin/clavulanate to 89% for cefaclor; for cefprozil, this rate was 84% and 85% in the two studies, respectively. In the first study, cefprozil was superior to amoxicillin/clavulanate in the satisfactory clinical response rate for Streptococcus pneumoniae (P = .049), but response rates were similar for Haemophilus influenzae and Moraxella catarrhalis. Significantly more patients treated with amoxicillin/clavulanate (P less than .001) in the first study or cefixime (P less than .01) in the second study developed diarrhea than did those treated with cefprozil. We conclude that cefprozil therapy for otitis media in children produces clinical and bacteriologic response rates similar to those seen with amoxicillin/clavulanate, cefixime, or cefaclor. Furthermore, diarrhea was significantly less common with cefprozil than with cefixime or amoxicillin/clavulanate.
在两项针对中耳炎患儿的随机临床试验中，将头孢丙烯的疗效和安全性与阿莫西林/克拉维酸（n = 530）以及头孢克洛和头孢克肟（n = 394）进行了比较。接受每种药物治疗方案的患者临床治愈或改善率相似，阿莫西林/克拉维酸的治愈率为78%，头孢克洛为89%；在两项研究中，头孢丙烯的治愈率分别为84%和85%。在第一项研究中，头孢丙烯在肺炎链球菌的临床满意反应率方面优于阿莫西林/克拉维酸（P = 0.049），但对流感嗜血杆菌和卡他莫拉菌的反应率相似。在第一项研究中，接受阿莫西林/克拉维酸治疗的患者（P < 0.001）或在第二项研究中接受头孢克肟治疗的患者（P < 0.01）出现腹泻的人数明显多于接受头孢丙烯治疗的患者。我们得出结论，儿童中耳炎使用头孢丙烯治疗产生的临床和细菌学反应率与阿莫西林/克拉维酸、头孢克肟或头孢克洛相似。此外，与头孢克肟或阿莫西林/克拉维酸相比，头孢丙烯引起腹泻的情况明显较少。
