Effect of Erythromycin on Adenoid Bacteria

Abstract

Seventy-eight patients with secretory otitis media were given erythromycin ethylsuccinate 50 mg/kg/day, divided into 2 doses, for 7-8 days before undergoing adenoidectomy and tympanostomy. Nasopharyngeal swabs for bacterial culture were obtained before medication and at surgery and the adenoid homogenate was also studied for bacteria. Pneumococci and Branhamella strains became significantly reduced, while Hemophilus influenzae showed no change. Pneumococcus and Branhamella strains partially returned one month after surgery and in part were found in patients who had not had these strains before antimicrobial therapy. Erythromycin ethylsuccinate can sterilize neither the adenoids nor the middle ear space if the causative agent is Hemophilus influenzae.

Alterations in the Nasopharyngeal Bacterial Flora after Adenoidectomy in Children: A Systematic Review

“…Nasopharyngeal colonization of Staphylococcus aureus decreased in four of six studies 4,7,8,12. A pronounced decrease of group A beta‐hemolytic streptococci carriage was observed in all studies 4,7,8,10–12. Carriage of Moraxella catarrhalis , however, barely changed following surgery.…”

“…The first subgroup concerns children with sinonasal symptoms, that is, those with a chronically hypertrophied and infected adenoid 4,7,8. The second concerns children with middle ear disease, i.e., otitis prone2 or those with otitis media with effusion 10,11. The third subgroup includes children with diverse symptoms related to the adenoid and/or tonsils 9,10…”

“…In three studies it cannot be determined reliably whether the effect of adenoidectomy on the nasopharyngeal flora was caused by the surgery alone. Palva et al10 administered antibiotics to all patients before surgery. Tomonaga et al11 poorly described the methods of microflora assessment after adenoidectomy.…”

“…Third, the postoperative swabs were taken after a relatively short period, varying from 10 days to three months in almost all included studies. 2,4,7,8,10,11 Therefore, it is impossible to draw conclusions on the long-term effect of adenoidectomy on the nasopharyngeal flora, and the long-term clinical beneficial effect of adenoidectomy remains to be proven.…”

“…4,7,8,12 A pronounced decrease of group A beta-hemolytic streptococci carriage was observed in all studies. 4,7,8,[10][11][12] Carriage of Moraxella catarrhalis, however, barely changed following surgery. In contrast, the prevalence of nonpathogenic nasopharyngeal flora increased after adenoidectomy in all studies 2,4,7-10,12 but one.…”