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Acute otitis media caused by drug-resistant bacteria: correlation with antibiotic treatment

Koichi Sakakura1, Kazuaki Chikamatsu, Michiyo Furukawa

  • 1Department of Otolaryngology--Head and Neck Surgery Gunma University Graduate School of Medicine, Japan.

Acta Oto-Laryngologica
|October 30, 2004
PubMed
Abstract

Insights

Drug-resistant bacteria are increasingly causing acute otitis media (AOM) in children. Inappropriate antibiotic use is common, highlighting the need for susceptibility testing and optimized treatment strategies to combat rising resistance.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Acute otitis media (AOM) is a common childhood infection.
  • Emerging antibiotic resistance in bacteria like *Staphylococcus pneumoniae* (DRSP) and *Haemophilus influenzae* (BLNAR) complicates AOM management.
  • Understanding resistance trends and antibiotic associations is crucial.

Purpose of the Study:

  • To investigate the trends of AOM caused by drug-resistant *Staphylococcus pneumoniae* (DRSP) and beta-lactamase-negative ampicillin-resistant *Haemophilus influenzae* (BLNAR).
  • To analyze the relationship between antibiotic usage for AOM and the isolation of specific bacterial pathogens.

Main Methods:

  • Bacterial isolation and antimicrobial susceptibility testing were performed on middle ear fluid specimens from children diagnosed with AOM.
  • Clinical data, including prior antibiotic exposure within 30 days, were collected and analyzed.

Main Results:

  • Drug-resistant *Staphylococcus pneumoniae* (DRSP) accounted for 59.3% of *S. pneumoniae* isolates, and BLNAR represented 26.0% of *H. influenzae* isolates.
  • AOM cases caused by DRSP and BLNAR showed a year-on-year increase.
  • 32% of AOM cases received inappropriate antibiotic treatment, while 32% of DRSP AOM and 50% of BLNAR AOM cases were treated with antibiotics demonstrating high in vitro susceptibility.

Conclusions:

  • Clinicians should consider tympanocentesis or myringotomy with susceptibility testing for appropriate antibiotic selection in AOM management.
  • Optimizing antibiotic dosage and duration, alongside appropriate drug selection, is essential.
  • Horizontal transmission, particularly in daycare settings, may contribute to the rapid spread of drug-resistant bacteria in AOM.

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