ABSTRACT
Cefotaxime levels were measured in the middle ears of 12 children, after operations for insertion of a transtympanic aerator for serous or relapsing otitis. Mean auricular cefotaxime levels were 4,3 and 5,1 mcg/ml on the right and left respectively. Mean serum level one hour after 25 mg/kg i.m. was 14,5 mcg/ml. In can be concluded that cefotaxime penetrates effectively into the middle ear. Its use should be reserved for difficult or menacing cases of otitis, but its bacteriological activity with regard to Haemophilus influenzae and certain enterobacteria is of value in cases where ampicillins may be ineffective due to resistance of strains.
Subject(s)
Cefotaxime/metabolism , Ear, Middle/metabolism , Biological Availability , Child , Child, Preschool , Female , Humans , Infant , Male , Otitis Media with Effusion/drug therapy , Otitis Media with Effusion/metabolism , Recurrence , Time FactorsABSTRACT
On the basis of 4 cases of partial chondronecrosis of the cricoid after prolonged intubation, the authors review the literature which contains very few similar cases. With regard to pathogenesis, in the light of experimental studies and clinical findings, they emphasize the importance of two lesional factors: excessive diameter of the intubation tube and excessive deflection of the patients' head. All of these factors increase the pressure applied by the tube to the region inferior to the posterior commissure. These parameters would appear to be more important than the duration of intubation itself. The prognosis of these lesions is related to the extent of necrosis: poor when the latter involves the major part of the chaton, generally good when it is limited to partial lysis of the cartilage which may be associated with arytenoid sequestration. Calibration procedures were used in each case. It should be borne in mind that such methods are inadequate for the treatment of massive chondronecrosis which requires repeated operation.
