Update on antimicrobial therapy for otitis media and sinusitis in children

Acute otitis media and chronic otitis media with effusion are generally caused in children by the bacteria found in the nasopharynx. In growing numbers of young patients, beta-lactamase-producing strains of Branhamella catarrhalis and Staphylococcus aureus have recently emerged as causative organisms. The antimicrobial agent selected for treatment should be effective against whatever pathogens have been associated with failures of symptomatic treatment in the community. Acute or chronic sinusitis in children is overlooked and poorly understood because so many children have frequent episodes of upper respiratory infection. To relieve acute symptoms and prevent suppurative complications, antimicrobial treatment is indicated. Children with persistent pain or fever may require surgical intervention and/or treatment with another antimicrobial agent. Recurrent acute sinusitis needs further evaluation and may be associated with a tooth abscess or cystic fibrosis.