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Bacteriología de la otitis media aguda en adultos
S E Celin1, C D Bluestone, J Stephenson
1Department of Otolaryngology, University of Pittsburgh, School of Medicine, PA.
JAMA
|October 23, 1991
Resumen
La otitis media aguda en adultos a menudo es causada por Haemophilus influenzae y Streptococcus pneumoniae. La amoxicilina se recomienda como tratamiento de primera línea, con antibióticos de espectro más amplio reservados para casos específicos.
Área de la Ciencia:
- La otorrinolaringología otorrinolaringología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Bacteriología Bacteriología.
Sus antecedentes:
- La otitis media aguda (OMA) es común en niños, pero los datos recientes sobre la bacteriología de la OMA en adultos en los EE.UU. son limitados.
- La prevalencia de Haemophilus influenzae en adultos AOM no ha sido bien documentada.
Objetivo del estudio:
- Para determinar la bacteriología de la otitis media aguda en adultos.
- Proporcionar datos recientes sobre los organismos causantes, en particular el Haemophilus influenzae.
Principales métodos:
- Se recogieron aspirados del oído medio a través de miringotomía de 34 pacientes adultos.
- Los pacientes fueron tratados con cefuroxima axetil y seguidos durante 6 semanas.
- Se realizaron cultivos aeróbicos y anaeróbicos.
Principales resultados:
- Haemophilus influenzae (26%) y Streptococcus pneumoniae (21%) fueron las bacterias más comunes identificadas.
- La producción de beta-lactamasa se observó en el 9% de los aislados.
- El 22% de los aislados de H. influenzae produjeron beta-lactamasa.
Conclusiones:
- La amoxicilina se sugiere como una terapia empírica de primera línea adecuada para la OMA en adultos, similar al tratamiento pediátrico.
- Los antibióticos que no son efectivos contra H. influenzae no se recomiendan para el tratamiento inicial.
- Los antibióticos de espectro más amplio como la cefuroxima axetil no son rutinariamente necesarios, pero son útiles para los organismos productores de beta-lactamasas o los fracasos del tratamiento.
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