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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
PubMed

Insights

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.

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