This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (19)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Middle/ External Ear Disorders  • Pediatric Otolaryngology  • Alert me on articles by topic

Itzhak Brook, MD, MSc; Alan E. Gober, MD

Arch Otolaryngol Head Neck Surg. 1998;124:1350-1352.

Objective  To identify the pathogens isolated from children with acute otitis media who did not respond to antimicrobial drug therapy.

Methods  Retrospective analysis of cultures obtained by tympanocentesis from 46 children.

Results  Organisms were recovered from 34 children (74%), and 43 isolates were recovered from these individuals. The organisms were Streptococcus pneumoniae (16 isolates), Haemophilus influenzae non–type b (12 isolates), Moraxella catarrhalis (5 isolates), Streptococcus pyogenes (5 isolates), Staphylococcus aureus (3 isolates), and Peptostreptococcus species (2 isolates). Resistance to the antimicrobial agent used was found in 27 (63%) of 43 isolates found in 22 patients (48%). Of patients who did not respond to amoxicillin therapy, H influenzae predominated. Streptococcus pneumoniae was recovered from 5 (56%) of 9 of those who did not respond to trimethoprim and sulfamethoxazole therapy, 4 (44%) of 9 patients after azithromycin therapy, 3 (25%) of 12 patients after amoxicillin therapy, and 2 (40%) of 5 patients after cefixime therapy. Streptococcus pyogenes was recovered from 2 (40%) of 5 patients after trimethoprim and sulfamethoxazole therapy and from 2 (40%) of 5 patients after cefixime therapy.

Conclusions  The data illustrate the relation between resistance to antimicrobial drug therapy and failure of patients with otitis media to improve. They also highlight the importance of diagnostic tympanocentesis in establishing the presence of resistant microorganisms.

From the Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Intranasal Immunization with a Colloid-Formulated Bacterial Extract Induces an Acute Inflammatory Response in the Lungs and Elicits Specific Immune Responses
Rial et al.
Infect. Immun. 2004;72:2679-2688.
ABSTRACT | FULL TEXT  

Treatment of Acute Otitis Media Consensus Recommendations
Hoberman et al.
CLIN PEDIATR 2002;41:373-390.
ABSTRACT