Comparison of amoxicillin administered twice and three times daily in children with acute otitis media

Eur J Pediatr. 2023 Dec;182(12):5599-5605. doi: 10.1007/s00431-023-05243-2. Epub 2023 Oct 10.

Abstract

To compare the effectiveness of amoxicillin administered in regimens of two or three daily doses in children with acute otitis media (AOM). As a secondary aim, we measured and compared treatment adherence between the two groups.A prospective observational study was conducted in the emergency department of a children's hospital.We recruited a total of 353 patients having a median age of 1.58 years. Twice-daily dosing was prescribed to 58%, while 42% received three doses per day. The clinical course of AOM was favourable in 92% of the patients who received two doses of amoxicillin and in 95% of those who received three doses (p = 0.25). Four patients (1%) had persistent symptoms beyond day 7. None developed intracranial complications. In the group receiving three doses daily, 31% reported difficulties with the dosing schedule, and 9.6% faced challenges when administering the medication at the specified volume, compared with 5.8% and 25% of those who received the two-dose regimen, respectively. Conclusion: Twice-daily amoxicillin has similar efficacy to a three-dose daily regimen and can offer advantages for caregivers in terms of administration schedule. What is Known: • Amoxicillin given in two daily doses is as effective as a three doses regimen in the treatment of acute otitis media in children. • The lower the number of daily doses, the higher the adherence to a drug treatment. What is New: • Administration of amoxicillin in twice-daily doses may improve adherence, as it is less frequently associated with family-perceived problems with dosing schedules.

Keywords: Amoxicillin; Antibiotic; Otitis.

Publication types

  • Observational Study

MeSH terms

  • Acute Disease
  • Amoxicillin* / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Humans
  • Infant
  • Otitis Media* / drug therapy
  • Treatment Outcome

Substances

  • Amoxicillin
  • Anti-Bacterial Agents