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Antibiotic susceptibility of acute otitis media pathogens in otitis-prone Belgian children

Muriel J P van Kempen1, Mario Vaneechoutte, Geert Claeys

  • 1Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.

European Journal of Pediatrics
|August 24, 2004
PubMed
Abstract

Insights

Antimicrobial resistance rates for common acute otitis media pathogens were studied in Belgian children. Otitis-prone children showed higher resistance, suggesting amoxicillin for treatment and caution with macrolides.

Area of Science:

  • Microbiology
  • Pediatric Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Recurrent acute otitis media (AOM) poses a significant challenge in pediatric care.
  • Understanding the antimicrobial susceptibility of common AOM pathogens is crucial for effective treatment.
  • Previous studies indicate regional variations in pathogen resistance patterns.

Purpose of the Study:

  • To determine the antimicrobial susceptibility profiles of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in children with recurrent AOM.
  • To compare resistance rates between nasopharyngeal and middle ear isolates.
  • To assess the impact of being 'otitis-prone' on antimicrobial resistance.

Main Methods:

  • A regional surveillance study was conducted between January 1999 and January 2002.
  • Antimicrobial susceptibility testing was performed on 149 S. pneumoniae, 246 H. influenzae, and 119 M. catarrhalis strains.
  • Isolates were obtained from the nasopharynx or middle ear of 74 children with recurrent AOM, predominantly otitis-prone.

Main Results:

  • Overall pneumococcal resistance to penicillin was 9.4%, with higher rates for cotrimoxazole (25.5%) and erythromycin (38.9%).
  • Antimicrobial-non-susceptible S. pneumoniae were more prevalent in middle ear isolates and in otitis-prone children.
  • Otitis-prone children harbored more multidrug-resistant pneumococci (24.3% vs 7.4%).
  • H. influenzae showed 17.1% ampicillin resistance and 16.3% cotrimoxazole resistance; M. catarrhalis had 92.4% ampicillin resistance.

Conclusions:

  • Belgian children with frequent AOM exhibit relatively favorable antibiotic resistance rates compared to international data.
  • Otitis-prone children represent a high-risk group with increased antimicrobial and multidrug-resistant pneumococci.
  • High-dose amoxicillin is recommended for indicated antimicrobial therapy in this group; macrolide use is discouraged.

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