We acknowledge that there are different ways of determining the prescribed dose of trimethoprim/sulfamethoxazole, which may cause confusion in clinical practice. The children with chronic otitis media who participated in our trial received trimethoprim/sulfamethoxazole at a dose of 18 mg/kg, 2 times per day (ie, 18 mg/kg twice daily, for a total of 36 mg/kg per day). This is the typical dose of trimethoprim/sulfamethoxazole in the Netherlands (see www.fk.cvz.nl).

The trimethoprim/sulfamethoxazole suspension is a combination of trimethoprim and sulfamethoxazole in a ratio of 1:5. A dose of 18 mg of trimethoprim/sulfamethoxazole per kg twice daily is the same as 3 mg of trimethoprim per kg twice daily, for a total of 6 mg of trimethoprim per kg per day. This dose is slightly lower than the typical US dose for mild-to-moderate infections (8–12 mg of trimethoprim per kg per day).

With the doses used in our study, adverse effects...

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