Cefixime in the treatment of upper respiratory tract infections and otitis media

An increasing number of clinical failures has been noted after treatment of upper respiratory tract infection and acute otitis media with conventional antibiotics. At present, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and group A beta-hemolytic streptococcus (GABHS) are the bacterial pathogens most frequently responsible for these infections. Although GABHS has so far not developed penicillin resistance, the frequency of bacteriological failures with either benzathine penicillin or penicillin V has increased. Firstly, a number of hypotheses have been put forward to explain this, including poor patient compliance and inactivation by beta-lactamase-producing oropharyngeal flora. Secondly, this has added to the demand for new agents to treat resistant streptococci. Cefixime, an orally active third-generation cephalosporin, has attracted considerable attention following the results of numerous clinical studies. Comparative studies between cefixime and conventional antibiotics for the treatment of upper respiratory tract infections and otitis media are summarized.