Abstract
This study evaluated the efficacy and safety of a high-dose cefditoren pivoxil (CDTR-PI ; 6 mg/kg, t.i.d.) in 194 children that were diagnosed with severe acute rhinosinusitis according to “the 2010 Clinical Practice Guidelines for the Diagnosis and Treatment of Acute Rhinosinusitis” and had no response to clavulanic acid/amoxicillin ( 1 : 14 ; CVA/AMPC ⟨1 : 14⟩) therapy for 5 days. The rate of improvement obtained as a result of the administration of CDTR-PI to the children for 5 days was 91%. Two hundred eighty-eight pathogenic bacterial strains were isolated from purulent nasal discharge, Streptococcus pneumoniae (65 strains) and Haemophilus influenzae (169 strains) accounting for 82% of the total. The MIC90 of CDTR was 0.5μg/ml for both S. pneumoniae and H. influenzae. The pathogen was H. influenzae in all 17 of the cases that did not respond to the CDTR-PI treatment, and all of these cases were cured by the administration of azithromycin for 3 days and nasal aspiration daily. A dverse reactions to CDTR-PI included 21 cases of diarrhea (11%). In conclusion, the results support the efficacy of high-dose CDTR-PI for children with severe acute rhinosinusitis that do not respond to CVA/AMPC ( 1 : 14) therapy.
