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The Scientific World Journal
Volume 2014 (2014), Article ID 965096, 6 pages
http://dx.doi.org/10.1155/2014/965096
Research Article

High-Dose Amoxicillin with Clavulanate for the Treatment of Acute Otitis Media in Children

1Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
2Department of Otorhinolaryngology, National Yang-Ming University School of Medicine, No. 155, Section 2, Li-Nong Street, Taipei 11217, Taiwan
3Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan
4Department of Medicine, National Yang-Ming University School of Medicine, No. 155, Section 2, Li-Nong Street, Taipei 11172, Taiwan
5Institute of Pharmacology, National Yang-Ming University School of Medicine, No. 155, Section 2, Li-Nong Street, Taipei 11217, Taiwan

Received 23 November 2013; Accepted 22 December 2013; Published 8 January 2014

Academic Editors: J. M. Coticchia, R. Matalon, C. O’Morain, and P. A. Schachern

Copyright © 2014 Chia-Huei Chu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. This study uses the acute otitis media clinical practice guideline proposed in 2004 as a reference to evaluate whether antibiotics doses that are in line with the recommendations lead to better prognosis. The study also attempts to clarify possible factors that influence the outcome. Study Design. Retrospective cohort study. Subjects and Methods. A total of 400 children with acute otitis media were enrolled. The dosage of amoxicillin was considered to be appropriate when in accord with clinical practice guidelines, that is, 80–90 mg/kg/day. The outcome was defined according to the description of tympanic membrane on medical records. Multivariate logistic regression was used to analyze the relationship between antibiotic dosage and prognosis after adjusting for baseline factors. Results. The majority of prescriptions were under dosage (89.1%) but it was not noticeably associated with outcome ( ). The correlation between under dosage and poor prognosis was significant in children below 20 kg with bilateral acute otitis media (odds ratio 1.63; 95% CI 1.02–2.59, ). Conclusion. Treating acute otitis media in children, high-dose amoxicillin with clavulanate as recommended in the clinical practice guideline was superior to conventional doses only in children under 20 kg with bilateral diseases.