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Persistent purulent otitis media

R H Schwartz, W J Rodriguez, W N Khan

    Clinical Pediatrics
    |July 1, 1981
    PubMed

    Insights

    Many children with acute otitis media did not respond to common antibiotics. Persistent infections often showed abscessed eardrums, with ampicillin-resistant Haemophilus influenzae frequently found in middle-ear cultures.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Microbiology

    Background:

    • Acute otitis media (AOM) is a common childhood infection.
    • Antibiotic resistance is a growing concern in treating pediatric infections.
    • Standard antibiotic courses may fail in some cases of AOM.

    Purpose of the Study:

    • To evaluate the treatment outcomes of acute otitis media in children.
    • To identify pathogens and their antibiotic susceptibility in persistent AOM cases.

    Main Methods:

    • Retrospective analysis of 429 children with AOM.
    • Follow-up evaluation of treatment response after 10-14 days of ampicillin, amoxicillin, or erythromycin/sulfisoxazole.
    • Myringotomy and middle-ear fluid culture in 45 children with persistent purulent AOM.

    Main Results:

    • 11% of children were unresponsive to initial antibiotic treatment.
    • Persistent purulent AOM was associated with immobile, bulging, abscessed tympanic membranes.
    • Middle-ear cultures revealed ampicillin-resistant Haemophilus influenzae in 31% of cases.
    • Ampicillin-susceptible pathogens (H. influenzae, S. pneumoniae) were found in 51% of cases.

    Conclusions:

    • A significant proportion of pediatric AOM cases show resistance to common antibiotics.
    • Haemophilus influenzae, including ampicillin-resistant strains, is a key pathogen in persistent AOM.
    • Myringotomy and culture are valuable for identifying causative agents in treatment failures.

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