[A clinicobacteriologic study on clavulanic acid/amoxicillin in pediatric sinusitis]

Area of Science:

• Pediatric infectious diseases
• Clinical microbiology
• Pharmacology

Background:

• Pediatric sinusitis is frequently caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
• Increasing prevalence of drug-resistant Streptococcus pneumoniae (PRSP) poses a therapeutic challenge.
• Amoxicillin is a common treatment, but resistance patterns necessitate evaluation of alternative therapies.

Purpose of the Study:

• To compare the clinical and bacteriological efficacy of clavulanic acid/amoxicillin (CVA/AMPC) versus amoxicillin (AMPC) in treating pediatric sinusitis.
• To assess the antimicrobial activity of CVA/AMPC against prevalent sinusitis pathogens.
• To evaluate the incidence of drug resistance in isolated bacteria.

Main Methods:

• Clinical and bacteriological study conducted in 11 general practice settings.
• Identification and susceptibility testing of bacterial isolates from middle meatus and nasopharynx.
• Comparison of clinical efficacy, bacteriological efficacy, and adverse reactions between CVA/AMPC and AMPC treatment groups.

Main Results:

• Streptococcus pneumoniae (32.2%), Haemophilus influenzae (32.0%), and Moraxella catarrhalis (25.1%) were the primary isolates.
• 62.1% of S. pneumoniae isolates were resistant (PRSP), with increasing prevalence.
• CVA/AMPC exhibited superior antimicrobial activity (MIC90) and significantly higher clinical (78%) and bacteriological (58%) efficacy compared to AMPC.
• Adverse reactions were similar between groups (11.2% for CVA/AMPC).

Conclusions:

• CVA/AMPC is a more effective treatment for pediatric sinusitis than AMPC, particularly against resistant strains.
• The study highlights the growing issue of drug-resistant S. pneumoniae in pediatric sinusitis.
• CVA/AMPC offers a favorable risk-benefit profile for managing pediatric sinusitis.