Published online November 30, 2007
PEDIATRICS Vol. 120 No. 6 December 2007, pp. 1403-1404 (doi:10.1542/peds.2007-2717)
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LETTER TO THE EDITOR

Effectiveness of Trimethoprim/Sulfamethoxazole for Children With Chronic Active Otitis Media: In Reply

Erwin L. van der Veen, MD
Anne G. M. Schilder, MD, PhD
Maroeska M. Rovers, PhD
Department of Otorhinolaryngology
University Medical Center Utrecht
3584 AB Utrecht, Netherlands

We acknowledge that there are different ways of determining the prescribed dose of trimethoprim/sulfamethoxazole, which may cause confusion in clinical practice. The children with chronic otitis media who participated in our trial received trimethoprim/sulfamethoxazole at a dose of 18 mg/kg, 2 times per day (ie, 18 mg/kg twice daily, for a total of 36 mg/kg per day). This is the typical dose of trimethoprim/sulfamethoxazole in the Netherlands (see www.fk.cvz.nl).

The trimethoprim/sulfamethoxazole suspension is a combination of trimethoprim and sulfamethoxazole in a ratio of 1:5. A dose of 18 mg of trimethoprim/sulfamethoxazole per kg twice daily is the same as 3 mg of trimethoprim per kg twice daily, for a total of 6 mg of trimethoprim per kg per day. This dose is slightly lower than the typical US dose for mild-to-moderate infections (8–12 mg of trimethoprim per kg per day).

With the doses used in our study, adverse effects such as hyperkalemia, anemia, thrombocytopenia, and leukopenia did not occur.1

REFERENCE

  1. van der Veen EL, Rovers MM, Albers FW, Sanders EA, Schilder AG. Effectiveness of trimethoprim/sulfamethoxazole for children with chronic active otitis media: a randomized, placebo-controlled trial. Pediatrics. 2007;119 :897 –904[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics

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