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Bacterial interference in the nasopharynx following antimicrobial therapy of acute otitis media
1Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
Abstract:
The effect on the nasopharyngeal bacterial flora of therapy for 10 days with co-amoxiclav or cefprozil was studied in 50 children with acute otitis media. Before therapy, potential pathogens (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) were isolated in 14 (56%) of those treated with co-amoxiclav and 15 (60%) of those treated with cefprozil. Following therapy, the reduction in the number of these pathogens was the same in the two groups. However, differences between the groups were noted in the recovery of organisms with interfering capability, namely alpha-haemolytic streptococci, Peptostreptococcus anaerobius and Prevotella melaninogenica. Fifty interfering organisms were recovered from each group before therapy. After therapy with co-amoxiclav or cefprozil their number declined to 11 and 42, respectively (P< 0.001).
Insights
Co-amoxiclav and cefprozil equally reduced common pathogens in children with acute otitis media. However, co-amoxiclav significantly impacted beneficial interfering bacteria more than cefprozil.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Pharmacology
Background:
- Acute otitis media (AOM) is a common childhood infection often treated with antibiotics.
- Nasopharyngeal bacterial flora plays a role in respiratory health and pathogen colonization.
- Understanding the impact of antibiotics on this flora is crucial for treatment strategies.
Purpose of the Study:
- To compare the effects of co-amoxiclav and cefprozil on nasopharyngeal bacterial flora in children with AOM.
- To assess the impact of these antibiotics on both potential pathogens and interfering organisms.
Main Methods:
- A study involving 50 children diagnosed with acute otitis media.
- Treatment administered for 10 days with either co-amoxiclav or cefprozil.
- Nasopharyngeal bacterial flora analysis performed before and after antibiotic therapy.
Main Results:
- Both co-amoxiclav and cefprozil demonstrated similar efficacy in reducing key pathogens like Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- A significant difference was observed in the recovery of interfering organisms (alpha-haemolytic streptococci, Peptostreptococcus anaerobius, Prevotella melaninogenica).
- Co-amoxiclav therapy led to a greater reduction in interfering organisms (from 50 to 11) compared to cefprozil (from 50 to 42) (P<0.001).
Conclusions:
- While both antibiotics effectively target common AOM pathogens, co-amoxiclav has a more pronounced disruptive effect on the protective nasopharyngeal bacterial flora.
- This differential impact on interfering organisms may have implications for recurrent infections or the development of resistance.
- Further research is warranted to elucidate the long-term consequences of this observed difference in flora modulation.