[Bacterial pathogens causing acute otitis media]

The objectives were to assess the prevalence of etiological agents of acute otitis media (AOM) in children, age distribution of patients, frequency of the disease throughout the year, prescribed antibiotics, risk factors and complications.

Included in the study were 100 children and adolescents aged 0 to 18 years who had been diagnosed with AOM. From these patients, swabs for culture were obtained from the middle ear after paracentesis or perforation of the ear drum.

Over the study period, a total of 111 isolates were obtained from 100 patients. The most prevalent etiological agents were Streptococcus pneumoniae (29 %), Streptococcus pyogenes (19 %) and Haemophilus influenzae (14 %). The frequency of other bacterial species was below 5 %; twenty-one isolates were negative (19 %). Staphylococcus aureus was identified in 15 cases (14 %); of those, 9 cases had another pathogen. The rates of agents were different in patients with spontaneous perforation. The most frequent etiological agents were Streptococcus pyogenes (24 %), Haemophilus influenzae (20 %), Staphylococcus aureus (17 %) and Streptococcus pneumoniae (15 %). Negative findings were noted in 20 %. The most prescribed antibiotic was amoxicillin-clavulanate (27 %), followed by phenoxymethylpenicillin (21 %) and cefuroxime (15 %). No antibiotics were administered in 20 % of cases and 3 % of patients received only local antibiotics. Complications (mastoiditis) developed in two children (2 %).

The study showed that Streptococcus pneumoniae was the most prevalent etiological agent in children with OMA. After spontaneous perforation, however, these were replaced by Streptococcus pyogenes and Haemophilus influenzae. For empirical therapy, the most frequent drugs were amoxicillin-clavulanate, phenoxymethylpenicillin and cefuroxime. The initial empirical therapy had to be changed in only 2 % of the cases.