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Factors associated with acute otitis media in children due to penicillin intermediately resistant Streptococcus

K Tanaka1, T Matsui, T Tachibana

  • 1Department of Otolaryngology, Japanese Red Cross Medical Center, Hiroo 4-1-22, Shibuya-ku, Tokyo 150-8935, Japan. ktan-tky@umin.ac.jp

International Journal of Pediatric Otorhinolaryngology
|July 15, 2009
PubMed
Abstract

Insights

Recent penicillin antibiotic use increases the risk of acute otitis media (AOM) caused by penicillin-intermediate Streptococcus pneumoniae (PISP). This suggests antibiotic use may drive resistance in AOM pathogens.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Acute otitis media (AOM) is a common childhood infection.
  • Increasing antimicrobial resistance is a global health concern.
  • Penicillin-intermediate Streptococcus pneumoniae (PISP) poses a treatment challenge.

Purpose of the Study:

  • To investigate the association between recent antimicrobial use and AOM caused by PISP.
  • To evaluate the impact of antimicrobial resistance on AOM clinical presentation.

Main Methods:

  • Retrospective cohort study of infants (<24 months) diagnosed with S. pneumoniae AOM.
  • Data collected from April 2002 to March 2007.
  • Risk ratios calculated for PISP infection following recent antibiotic exposure.

Main Results:

  • 22 of 35 AOM cases were caused by PISP.
  • Recent penicillin antibiotic use within 1 month (aRR 1.99) and 1 week (aRR 1.93) was associated with PISP AOM.
  • No significant difference in clinical course between PISP and penicillin-susceptible S. pneumoniae (PSSP) infections.

Conclusions:

  • Recent penicillin antibiotic use may act as a selective pressure favoring PISP.
  • This highlights the need for judicious antibiotic stewardship in pediatric AOM management.

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