The clinical efficacy of
cefditoren pivoxil (
CDTR-PI) was evaluated for 43 pediatric patients with acute
otitis media or acute
sinusitis. The causative organisms were identified and their susceptibilities to 6 oral
beta-lactam antibiotics were measured;
ampicillin (ABPC),
cefaclor (CCL),
cefdinir (CFDN),
cefditoren pivoxil (
CDTR-PI),
cefteram pivoxil (CFTM-PI) and
cefpodoxime proxetil (CPDX-PR). The ages of 43 patients were distributed from 4 months to 10 years and 7 months, and especially children under 4 years accounted for 72% (31 cases). In 22 cases (51%), Haemophilus influenzae or Streptococcus pneumoniae were identified as the pathogens, but in 18 cases, no causative organisms were defined. Treatment by
CDTR-PI was successful in 12 cases out of 15 evaluable cases in which H. influenzae or S. pneumoniae were identified as the main causative organisms. From the susceptibility testing of them, some strains of H. influenzae were found to be ABPC-resistant and some strains of S. pneumoniae were
benzylpenicillin (PCG)-resistant. To support above clinical evaluation of
CDTR-PI, susceptibility testings on clinically isolated H. influenzae (81 strains) and S. pneumoniae (79 strains) were performed using above mentioned 6 oral
beta-lactam antibiotics. The MIC80s against H. influenzae were;
CDTR-PI 0.06 microgram/ml, CCL 2 micrograms/ml, CPDX-PR 0.125 microgram/ml, CFTM-PI 0.03 microgram/ml, CFDN 1 microgram/ml and ABPC 1 microgram/ml. Those against S. pneumoniae were;
CDTR-PI 0.5 microgram/ml, CCL > 4 micrograms/ml, CPDX-PR 2 micrograms/ml, CFTM-PI 1 microgram/ml, CFDN 2 micrograms/ml and ABPC 1 microgram/ml. From those results, it was concluded that
CDTR-PI or CFTM-PI may be preferable for the treatment of acute
otitis media and acute
sinusitis in children.