急性中耳炎に対するＴｅｂｉｐｅｎｅｍ ｐｉｖｏｘｉｌの有用性―スコアリング・システムを用いた重症度評価とその臨床効果―

Abstract

In recent years, high prevalence penicillin-resistant Streptococcus pnenumoniae (PRSP) strains and β-lactamase non-producing ampicillin-resistant Haemophilus influenzae (BLNAR) strains have been reported the treatment of acute otitis media (AOM) in children. Between September 2005 and March 2006, we performed a clinical efficacy study on Tebipenem-pivoxil (TBPM-PI) in children with acute otitis media. We assessed the severity of disease by using a scoring system based on symptoms and tympanic membrane changes, and a clinical efficacy study was carried out using the improvement in the score results cross linked in a table together with symptoms and TM findings and the objective grading of the physician in charge. 16 patients were enrolled in this study, ages were from 0 to 5 years old, with a median age of 3.50 years. S. pneumoniae, H. influenzae, and M. catarrhalis were detected as causative bacteria. The doses of TBPM-PI administered to children with AOM were 4 mg/kg b.i.d (10 cases) or 6 mg/kg b.i.d (6 cases) for seven days. The overall efficacy rates of TBPM-PI for AOM according to the clinical efficacy judged by the scoring system and the grading of attending physicians were 90.5% and 100%, respectively. The eradication rate of pathogens at the end of treatment was 4/4. Based on our results, the present study strongly suggested that TBPM-PI would be an effective antimicrobial agent against moderate to severe AOM. Moreover, the scoring system was very useful for the decision making regarding the appropriate treatment regimen of AOM.