Bacterial isolates and efficacy of antibiotics in acute otitis media in children

ABSTRACT

This research was done for study of bacterial isolates and efficacy of the antibiotics, amoxicillin, calvulanate amoxicillin and cefaclor, in AOM in children. 148 children with AOM were randomly assigned to receive a 10 day course of either treatment regimen. Aspiration of middle ear fluid for culture was done initially and repeated during treatment if fluid persisted. Bacterial isolates in initial aspirates were S. pneumonia [42%], H. influenzae[34%], S. pyogenes [9%], B. catarrhalis[6%], Staph. Aureus [5%] and nonpathogens [7%]. Isolated main strains were susceptible to the study antibiotics except 24% of isolates of H. influenzae, 67% of B. catarrhalis and 71% of Staph. Aureus were resistant to amoxicillin. Clinical responses were assessed at 3 and 10 days and 4 weeks later. On day 10 patients were either cured or unresolved with either drainage or persistent effusion. The cure rates were 71% for amoxicillin, 88% for clavulanate amoxicillin and 81% for cefaclor. However, the differences are not statistically significant. Recurrences during 4 weeks after treatment occurred in 15 children, 7 in amoxicillin, 3 antibiotics. While, in those with H. influenzae, cure rates were 60% for amoxicillin and 76% for cefaclor. Favorable clinical results were obtained with clavulanate amoxicillin and cefaclor as compared with amoxicillin, mainly in cases with H, Influenzae, B. catarrhalis and Staph. Aureus. This relates to amoxicillin resistant strains. Therefore, it would be prudent to consider them in the event of treatment failure and persistent effusion after amoxyclillin treatment or as initial therapy