Journal Article

Effect of erythromycin treatment delay on therapeutic outcome of experimental acute otitis media caused by <i>Streptococcus pneumoniae</i>

Carmina Martínez-Marín, Lorena Huelves, Gema del Prado, José I. García-Cía, Carlos Cenjor, Carmen Ponte, Juan J. Granizo and Francisco Soriano

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 56, issue 4, pages 783-786
Published in print October 2005 | ISSN: 0305-7453
Published online September 2005 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dki322
Effect of erythromycin treatment delay on therapeutic outcome of experimental acute otitis media caused by Streptococcus pneumoniae

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  • Medical Oncology
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Objective: To evaluate the effect of delayed administration of erythromycin in the course of acute otitis media caused by an erythromycin-susceptible Streptococcus pneumoniae strain in the gerbil model.

Methods: The bacterium was inoculated by transbullar challenge in the middle ear (ME) and antibiotic treatment at different doses was administered at various times thereafter.

Results: When 2.5 mg/kg of erythromycin was administered as a single dose 2, 5, 18 or 21 h post-inoculation (pi) the bacterial eradication rate was 55, 40, 0 and 0%, respectively. A higher dose (5 mg/kg) administered also as a single dose 2, 5, 18 and 21 h pi achieved bacterial eradication rates of 62.5, 43.8, 0 and 0%, respectively. Using a very high dose (50 mg/kg) repeated three times at 3 h intervals (total dose 150 mg/kg) and starting the treatment 21 h pi only achieved bacterial eradication in 25% of cases. The concentration of erythromycin achieved in the ME 90 min after administration of 5 mg/kg 5 or 21 h pi was very similar (0.74 and 0.79 mg/L) but the ME half-life was longer (98.2 min) with the early administration as compared with the delayed form (47.5 min), which could partially explain the different results. Further experiments showed that the failures observed with the delayed administration were not related to the time elapsed from antibiotic administration to ME sampling or selection of antibiotic-resistant mutants.

Conclusion: Bacteriological and clinical efficacies were significantly diminished if antibiotic administration was delayed.

Keywords: otitis; pneumococcal; therapy delay; gerbils

Journal Article.  2060 words. 

Subjects: Medical Oncology ; Critical Care

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