Expert Opinion on the Use of Oral Antibiotics with A Special Focus on Amoxicillin-Clavulanate and Cefuroxime for the Management of Respiratory Tract Infections and Otitis Media in Indian Settings

Abstract

Respiratory tract infections (RTIs) are a major public health concern due to their high morbidity and mortality rates, and widespread distribution. Studies regarding the expert opinion on current practices, clinical observations, and experiences related to the use of oral antibiotics primarily, amoxicillin-clavulanate and cefuroxime for managing respiratory tract infections (RTIs) and otitis media in Indian settings were scarce. So, a cross-sectional, questionnaire based study was conducted to collect opinion among physicians involved in treating RTIs and otitis media across India between June 2022 and December 2022. It was observed that managing upper respiratory tract infections (URTI), majority of the experts (94.1%) preferred amoxicillin + clavulanic acid over other oral antibiotics, such as cefpodoxime, cefixime, azithromycin, cefuroxime, and cefuroxime + clavulanic acid. Furthermore, 91% of the experts opined that amoxicillin with clavulanic acid was better for URTI than other antibiotics and 88% of the respondents preferred to prescribe amoxicillin with clavulanic acid in managing acute otitis media. Additionally, majority of the clinicians (81%) reported that cefuroxime was the most commonly used oral antibiotic for managing lower respiratory tract infections (LRTIs). Nearly 62% of clinicians opined that cefuroxime has better tissue penetration compared to other broad-spectrum antibiotics. Thus, it was found that experts recommended a combination of amoxicillin with clavulanic acid and cefuroxime for the treatment of RTIs. Amoxicillin with clavulanic acid was the preferred choice for managing URTIs and acute otitis media in children, while cefuroxime was favored for lower LRTIs due to its superior tissue penetration and broad-spectrum antibiotic properties.