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A systematic review and meta-analysis of antimicrobial resistance in paediatric acute otitis media

Michael W Mather1, Michael Drinnan2, John D Perry3

  • 1Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK; Department of Otolaryngology, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK.

International Journal of Pediatric Otorhinolaryngology
|May 16, 2019
PubMed
Abstract

Insights

This review found that Streptococcus pneumoniae, Haemophilus influenza, and Moraxella catarrhalis are the most common bacterial causes of acute otitis media (AOM) in children. Antimicrobial resistance in AOM-associated bacteria necessitates improved stewardship.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Acute otitis media (AOM) is a leading cause of antibiotic prescriptions in children globally.
  • Antimicrobial resistance (AMR) is a growing concern, driven by excessive antibiotic use.
  • Limited data exists on AMR patterns in bacteria causing pediatric AOM.

Purpose of the Study:

  • To systematically review and analyze bacterial prevalence in pediatric AOM.
  • To determine antimicrobial resistance patterns of common AOM pathogens.
  • To inform antimicrobial stewardship strategies for AOM treatment.

Main Methods:

  • Systematic review and meta-analysis of studies on pediatric AOM.
  • Searches conducted in Ovid Medline, Embase, and Cochrane Library.
  • Inclusion of 48 studies with 15,871 bacterial samples.

Main Results:

  • Bacterial pathogens were identified in only 67% of ear samples.
  • Key pathogens included Streptococcus pneumoniae (30%), Haemophilus influenza (23%), and Moraxella catarrhalis (5%).
  • Amoxicillin effectively treated 85% of bacterial AOM cases, amoxicillin-clavulanate 95%, and erythromycin 64%.

Conclusions:

  • Bacteriology and AMR patterns in pediatric AOM are characterized.
  • Approximately 15% of bacterial isolates showed amoxicillin resistance.
  • Local data on bacteriology and resistance is crucial for effective antimicrobial stewardship.
Keywords:
Antimicrobial resistanceBacteriologyOtitis media

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