Antibiotic susceptibility of acute otitis media pathogens in otitis-prone Belgian children

Kempen, Muriel J.P. van; Vaneechoutte, Mario; Claeys, Geert; Verschraegen, Gerda; Vermeiren, Judith S.J.; Dhooge, Ingeborg

doi:10.1007/s00431-004-1475-0

Cited by 11 publications

(5 citation statements)

References 23 publications

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“…Because of the increased incidence of Streptococcus pneumoniae with intermediary resistance [57,61], the dosage of amoxicillin should be doubled, i.e. 90 mg/kg per day given in three administrations as recommended by the Centers for Disease Control and Prevention [3].…”

Section: Treatment Of Aommentioning

confidence: 99%

What is new in otitis media?

Corbeel

2007

Eur J Pediatr

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The "wait and see" approach in acute otitis media (AOM), consisting of postponing the antibiotic administration for a few days, has been advocated mainly to counteract the increased bacterial resistance in respiratory infections. This approach is not justified in children less than 2 years of age and this for several reasons. First, AOM is an acute inflammation of the middle ear caused in about 70% of cases by bacteria. Redness and bulging of the tympanic membrane are characteristic findings in bacterial AOM. Second, AOM is associated with long-term dysfunction of the inflamed eustachian tube (ET), particularly in children less than 2 years of age. In this age group, the small calibre of the ET together with its horizontal direction result in impaired clearance, ventilation and protection of the middle ear. Third, recent prospective studies have shown poor long-term prognosis of AOM in children below 2 years with at least 50% of recurrences and persisting otitis media with effusion (OME) in about 35% 6 months after AOM. Viruses elicit AOM in about 30% of children. A prolonged course of AOM has been observed when bacterial and viral infections are combined because viral infection is also associated with ET dysfunction in young children. Bacterial and viral testing of the nasopharyngeal aspirate is an excellent tool both for initial treatment and recurrence of AOM. Antibiotic treatment of AOM is mandatory in children less than 2 years of age to decrease inflammation in the middle ear but also of the ET particularly during the first episode. The best choice is amoxicillin because of its superior penetration in the middle ear. Streptococci pneumoniae with intermediary bacterial resistance to penicillin are particularly associated with recurrent AOM. Therefore the dosage of amoxicillin should be 90 mg/kg per day in three doses. In recurrent AOM with β-lactamase-producing bacilli, amoxicillin should be associated with clavulanic acid at a dose of 6.4 mg/kg per day. The duration of the treatment is not established yet but 10 days is reasonable for a first episode of AOM. OME may be a precursor initiating AOM but also a complication thereof. OME needs a watchful waiting approach. When associated with deafness for 2-3 months in children over 2 years of age, an antibiotic should be given according to the results of the bacterial resistance in the nasopharyngeal aspirate. The high rate of complications of tympanostomy tube insertion outweighs the beneficial effect on hearing loss. The poor results of this procedure are due to the absence of effects on ET dysfunction. Pneumococcal vaccination has little beneficial effects on recurrent AOM and its use in infants needs further studies. Treatment with amoxicillin is indicated in all children younger than 2 years with a first episode of AOM presenting with redness and bulging of the tympanic membrane. Combined amoxicillin and clavulanic acid should be given in patients with β-lactamase-producing bacteria. The duration of treatment is estimated to be at least 10 days de...

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Section: Treatment Of Aommentioning

confidence: 99%

What is new in otitis media?

Corbeel

2007

Eur J Pediatr

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“…This particular group of children, often classified as 'otitis-prone', comprises 5-10% of all infants and is frequently referred to tertiary care centers for further therapy [10]. They are often exposed to antibiotics and were shown to harbor significantly more antimicrobial resistant and multiple drug resistant pneumococci in their nasopharynges compared with healthy infants [11,12]. Therefore, vaccination could provide a valuable therapeutic alternative in these children besides antimicrobial prophylaxis, tympanostomy tube insertion and adenoidectomy.…”

Section: Introductionmentioning

confidence: 98%

Pneumococcal conjugate vaccination in children with recurrent acute otitis media: A therapeutic alternative?

Kempen

Vermeiren

Vaneechoutte

et al. 2006

International Journal of Pediatric Otorhinolaryngology

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“…14 Bacterial resistance to antimicrobial agents has become an increasing problem in the treatment of OM. 8,15 A multicenter surveillance study, carried out in Asia and Europe, demonstrated a high prevalence of antimicrobial resistance among respiratory pathogens and important differences in antimicrobial resistance profiles between countries. 16 Pathogens that cause acute OM to become resistant to commonly used antibiotics.…”

Section: Introductionmentioning

confidence: 99%

“…16 Pathogens that cause acute OM to become resistant to commonly used antibiotics. 15,17,18 The increasing rates of antibiotic resistance are due to repeated exposure to these bacteria to antibiotics and the geographic spread of resistant strains. 19 The rapid emergence of multidrug-resistant OM in developing countries is a new potential threat to the survival of newborn babies and children.…”

Section: Introductionmentioning

confidence: 99%

Bacterial profile and antimicrobial susceptibility patterns of otitis media among children in Qatar

et al. 2019

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Background: Otitis Media (OM) common diseases affecting children below 5 years of age with a harmful effect on their hearing and health status. Data about the bacterial profile and current antimicrobial resistance status of Otitis Media in the region is scarce. Objective of this study determine the causative organisms of Otitis Media and antimicrobial susceptibility patterns among children in a Primary Health Care Corporation (PPHC) centers, Qatar.Methods: A cross-sectional study was conducted in PPHC from Jan 2016 to Dec 2017. A total of 181 patients with Otitis Media presented to PHCC centers were enrolled in the study. Socio-demographic and clinical data were documented and analysed.Results: A total of 181 children, an almost equal number of male (49.7%) and female (50.3%) participants were involved in the study. 51.4% of participants were ≤5 years of age. Bacteria isolated were: Pseudomonas Aeruginosa (27.6%), Hemophilus Influenza (13.3%), Staphylococcus Aureus (11.6%), Methicillin-Resistant Staphylococcus Aureus (MSRA) (11.0%), Streptococcus Pyogenes (10.5%), Streptococcus Pneumonia (6.6%), Moraxella Catarrhalis (2.2%), Klebsiella Pneumonia (0.6%). The sensitivity of Pseudomonas Aeruginosa was (100%) to cotrimoxazole, vancomycin, and piperacillin, (96%) to cefepime and gentamicin, and was (88.2%) to ciprofloxacin. MRSA sensitivity was (100%) to vancomycin, rifampicin, and teicoplanin, (89%) to clindamycin.Conclusion: Pseudomonas Aeruginosa was the most frequent isolated bacteria. An overall antimicrobial resistance pattern seen in bacteria isolates ranges from 0% to 66.7%. The antimicrobial-resistant rate was observed for Ampicillin, Augmentin, and cefuroxime whereas ciprofloxacin, cefepime, chloramphenicol, cotrimoxazole, gentamicin, vancomycin, and amikacin were found effective for the isolated resistant bacteria.

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Antibiotic susceptibility of acute otitis media pathogens in otitis-prone Belgian children

Cited by 11 publications

References 23 publications

What is new in otitis media?

What is new in otitis media?

Pneumococcal conjugate vaccination in children with recurrent acute otitis media: A therapeutic alternative?

Bacterial profile and antimicrobial susceptibility patterns of otitis media among children in Qatar

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