Archivos de Pediatría del Uruguay
versión impresa ISSN 0004-0584
AUERSPERG, Mercedes et al. Amoxicilina versus azitromicina en el tratamiento de otitis media aguda en niños asistidos en un centro de atención primaria. Arch. Pediatr. Urug. [online]. 2001, vol.72, n.1, pp. 6-11. ISSN 0004-0584.
Objectives: 1) To compare the efficacy of amoxicillin versus azithromycin in the treatment of acute otitis media (AOM) in children, in a Primary Care Center; 2) to train the medical staff of the Center in otoscopic technique. Methods: 51 children, 6 months to 5 years old, treated for AOM in the Centro Materno Infantil Maciel (Montevideo) between june 1997 and january 1998, were enrolled in a prospective trial.They were randomly assigned to one of two groups: 1) amoxicillin per os 50 mg/kg/day in 3 divided doses, during 10 days; 2)azithromycin per os in a single dose of 10 mg/kg/day, during 3 days.Three consecutive visits were planned (at day 5, 14 and 28) for clinical and otoscopic follow up. During the first month of the study physicians were trained in otoscopic technique by an otolaryngologist. Results: During the training period 32 otoscopic assessments were done; in 31 there was agreement in the diagnosis made by physician and otolaryngologist. Of the 51 children enrolled in the trial, AOM resolved satisfactorily in 77% and 81% of the patients in group 1 and 2 respectively. 53% of the patients in group1 and 86% in group 2 completed treatment, and follow up was achieved in 40% and 48% respectively. Neither resolution of AOM nor therapeutic failures showed statistically significant differences between both groups (p=0,56). Discussion: Recovery from AOM was similar in both groups, independently of treatment compliance, probably because spontaneous resolution is frequent in this disease. The high number of patients lost for planned follow up visits expresses difficulties in long lasting prospective studies. The most remarkable achievement of this study was the training of the medical staff in otoscopic technique, which will enhance appropiate management of AOM in the future.
Palabras llave : otitis media aguda; amoxicilina; azitromicina, niños; atención primaria.