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[Current bacteriologic status and therapeutic results in acute otitis media in children aged over 3 months]
Insights
This study analyzed bacteria in 355 children with acute otitis media. Amoxicillin alone is the primary treatment, with amoxicillin-clavulanic acid reserved for specific cases.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Otolaryngology
Context:
- Acute otitis media (AOM) is a common childhood illness.
- Bacteriological data on AOM pathogens are crucial for effective treatment strategies.
- Studies in Paris and Valognes, France, investigated AOM pathogens in children.
Purpose:
- To conduct a bacteriological study of middle ear effusions in children with AOM.
- To identify predominant bacterial pathogens and their antibiotic resistance patterns.
- To inform current treatment guidelines for pediatric AOM.
Summary:
- 355 children (3 months to 15 years) with AOM were studied.
- Predominant pathogens included Haemophilus, Streptococcus pneumoniae, and Staphylococcus.
- Amoxicillin alone is the recommended first-line treatment; amoxicillin-clavulanic acid is not.
- Trimethoprim-sulfamethoxazole is an alternative for penicillin-allergic patients.
Impact:
- Provides insights into the local epidemiology of AOM pathogens in children.
- Supports the continued use of amoxicillin as a first-line therapy for AOM.
- Highlights the need for ongoing surveillance of antibiotic resistance in pediatric AOM.
Abstract:
355 children, 3 months to 15 years old, presenting with acute otitis media, underwent a bacteriological study of otitis exsudate. From November 1985 to September 1987, 162 myringotomy and 149 acute otitis media spontaneously discharging were studied in Paris. From October 1981 to September 1987, 62 myringotomy and 46 spontaneously discharging acute otitis were studied in Valognes. There was none pathogenic bacterium in respectively 20 and 14% of the samples. Two or more pathogenic bacterium were isolated in 24 and 7% of the samples. In Paris as in Valognes, 3 pathogens were predominants: Haemophilus (17% were beta-lactamase producers), S. pneumoniae and Staphylococcus. There was only 5 and 3% Streptococcus pyogenes, 2% Branhamella catarrhalis in Paris, none in Valognes. Pseudomonas was present only in case of spontaneous otorrhea, even if recent. For the moment, the combination of amoxicillin with clavulanic acid is not our first treatment in case of acute otitis media in children. Actually we prescribe amoxicillin alone, 50 to 100 mg/kg/day. If the child is allergic to beta lactamin, we give him the combination of trimethoprime and sulfamethoxazole.