TABLE 5.

Antibiotic Treatment Choices for AOM

% of Responses
Pediatric ResidentsPracticing Pediatricians
PrecoursePostcoursePrecoursePostcourse
First or second choice for DRSP
 Amox/Clav ES70787080
 Higher-activity cephalosporin*8171016
 Lower-activity cephalosporin4111
 Azithromycin123172
 TMP/SMZ6121
First or second choice for β-lactamase + H influenzae
 Amox/Clav ES62716472
 Higher-activity cephalosporin1219921
 Lower-activity cephalosporin§5141
 Azithromycin166205
 TMP/SMZ5331
  • DRSP, drug-resistant S pneumoniae; TMP-SMZ, trimethoprim-sulfamethoxazole; Amox/Clav ES, amoxicillin/clavulanate extra strength, dosing at 80–100 mg/kg of amoxicillin.

  • * Higher-activity cephalosporins for DRSP were ceftriaxone, cefuroxime axetil, cefprozil, cefpodoxime proxetil, and cefdinir.

  • Lower-activity cephalosporins for DRSP were cefaclor, loracarbef, cefixime, and ceftibuten.

  • Higher-activity cephalosporins for β-lactamase + H influenzae were cefuroxime, ceftibuten, ceftriaxone, cefuroxime axetil, cefprozil, cefdinir, and cefixime.

  • § Lower-activity cephalosporins for β-lactamase + H influenzae were cefaclor and loracarbef.

  • Significant changes occurred pre- to postcourse for selection of amox/clav ES, 8% (CI: 2%–14%) and higher-activity cephalosporins, 9% change (CI: 4%–13%) among pediatric residents (P = 0.015 and <.001) for treatment of DRSP. Significant changes occurred pre- to postcourse for selection of amox/clav ES, 10% (CI: 7%–13%) and higher-activity cephalosporins, 6% change (CI: 4%–8%) among practicing pediatricians (P < .01 for both comparisons) for treatment of DRSP.

  • Significant changes occurred pre- to postcourse for selection of amox/clav, 9% change (CI: 2%–16%) and higher-activity cephalosporins, 7% change (CI: 2%–12%) among pediatric residents (P < .01 for both comparisons) for treatment of β lactamase + H influenzae. Significant changes occured pre- to postcourse for selection of amox/clav, 8% change (CI: 5%–11%) and higher-activity cephalosporins, 12% change (CI: 10%–14%) among practicing pediatricians (P < .001 for both comparisons) for treatment of β-lactamase–producing H influenzae.