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Effect of amoxicillin or clindamycin on the adenoids bacterial flora
1Department of Pediatrics, Georgetown University, USA. ib6@georgetown.edu
Insights
Clindamycin (C) and amoxicillin (Am) both reduced adenoid bacteria in children with recurrent otitis media. Clindamycin was more effective at reducing potential pathogens and beta-lactamase-producing bacteria.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Otolaryngology
Background:
- Recurrent otitis media (ROM) in children is often associated with bacterial colonization of adenoid tissue.
- Understanding the impact of antibiotic therapy on adenoid flora is crucial for managing ROM.
Purpose of the Study:
- To compare the effects of amoxicillin (Am) and clindamycin (C) on the adenoid bacterial flora in children with recurrent otitis media.
- To evaluate the reduction in overall bacterial load, potential pathogens, and beta-lactamase-producing bacteria.
Main Methods:
- A prospective randomized study involving 45 children undergoing adenoidectomy for ROM.
- Participants were divided into three groups: control (no therapy), amoxicillin therapy, or clindamycin therapy for 10 days.
- Quantitative cultures of core adenoid tissues were performed for aerobic and anaerobic bacteria.
Main Results:
- Both amoxicillin and clindamycin significantly reduced the total number of bacterial isolates compared to the control group.
- Clindamycin demonstrated a greater reduction in potential pathogens and beta-lactamase-producing bacteria compared to amoxicillin and the control.
- Predominant aerobic bacteria included streptococci, Haemophilus influenzae, Staphylococcus aureus, and Moraxella catarrhalis; prominent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium spp.
Conclusions:
- Clindamycin and amoxicillin are effective in reducing the bacterial load in adenoids of children with recurrent otitis media.
- Clindamycin shows superior efficacy in reducing specific bacterial populations, including potential pathogens and beta-lactamase-producing strains.
Objective:
We sought to compare the effect on the adenoid bacterial flora of patients with recurrent otitis media of antimicrobial therapy with amoxicillin (Am) or clindamycin (C). Patients and methods Forty-five children scheduled for elective adenoidectomy participated in a prospective randomized study. They were divided into 3 groups of 15 each to receive either no therapy (control) or 10 days of therapy with Am or C. Core adenoid tissues was quantitatively cultured for aerobic and anaerobic bacteria.
Results:
Polymicrobial aerobic-anaerobic flora were present in all instances. The predominant aerobes in all groups were alpha-hemolytic and gamma-hemolytic streptococci, Haemophilus influenzae, Staphylococcus aureus, group A beta-hemolytic streptococci, and Moraxella catarrhalis. The prominent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium spp. The number of isolates was significantly reduced in those treated with Am (n = 110, P < 0.05) or C (n = 58, P < 0.001) compared with control (n = 148). The number of bacteria per gram/tissue was lower in those treated with either antibiotics. The number of potential pathogens was lower in those treated with C compared with the other 2 groups (P < 0.001). The number of beta-lactamase-producing bacteria was lower in those treated with C than in those treated with Am (P < 0.025) or control (P < 0.001).
Conclusions:
These data illustrate the ability of C and, to a lesser degree, of Am to reduce the bacterial load as well as potential pathogens and beta-lactamase-producing bacteria from the adenoids of children with recurrent otitis media.