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Treatment failure in otitis media: an analysis
R Cohen1, F de la Rocque, M Boucherat
1Department of Microbiology, Intercommunal Hospital, Créteil, France.
Journal of Chemotherapy (Florence, Italy)
|September 1, 1994
Summary
Penicillin-resistant Streptococcus pneumoniae (PRP) frequently caused treatment failure in acute otitis media (AOM). Obligatory bacteriological sampling is recommended for antibiotic treatment failures involving PRP.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Epidemiology
Background:
- Antibiotic resistance is a growing concern in treating common infections.
- Penicillin-resistant pneumococci (PRP) pose a significant challenge in pediatric otitis media management.
- High rates of antibiotic resistance are reported in specific geographical areas.
Purpose of the Study:
- To investigate the role of PRP in treatment failures of acute otitis media (AOM).
- To assess antibiotic susceptibility patterns of Streptococcus pneumoniae in AOM treatment failures.
- To evaluate the impact of PRP on therapeutic outcomes in AOM.
Main Methods:
- An epidemiological study involving 293 children with AOM treated by ENT specialists.
- Bacteriological sampling to identify pathogens and assess antibiotic resistance.
- Analysis of treatment outcomes in relation to isolated pathogens and their resistance profiles.
Main Results:
- Streptococcus pneumoniae was the most common pathogen in treatment failures (55.1%).
- Serotype 23F was the predominant S. pneumoniae strain, with 86.4% exhibiting resistance or reduced susceptibility.
- PRP was implicated in 32 of 49 cases treated with beta-lactam antibiotics.
Conclusions:
- Multiresistant S. pneumoniae presents a serious therapeutic challenge in AOM.
- Myringotomy and bacteriological sampling should be mandatory for antibiotic treatment failures.
- Amoxicillin demonstrated the most activity among oral beta-lactams against these resistant strains.