The antibiotic treatment of acute otitis media and sinusitis in children.
The development of resistance among the bacterial pathogens causing acute otitis media and sinusitis in children is causing considerable concern. Although normally a mild infection, acute otitis media can produce serious complications with sequelae that can have long-lasting effects. High levels of resistance are now being seen in the three principal pathogens. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Most clinical trials comparing the efficacy of different antibiotics have failed to show differences in clinical efficacy. To overcome this problem, alternative methods of assessing antibiotics have been developed including the "in-vivo sensitivity test" proposed by Howie and retrospective analyses of treatment failures. The treatment of sinusitis is complicated by the difficulty in establishing a clear differential diagnosis. To date, no definitive trials of bacteriologic efficacy in children have been published.
Cohen
R
R
Department of Microbiology, Intercommunal Hospital, Creteil, France.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D006193:Haemophilus influenzae / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007769:Lactams; D018942:Macrolides; D008826:Microbial Sensitivity Tests; D001936:Moraxella catarrhalis / Q000187:drug effects; D010033:Otitis Media / Q000188:drug therapy*; D010403:Penicillin Resistance; D010406:Penicillins / Q000627:therapeutic use*; D012852:Sinusitis / Q000188:drug therapy*; D013296:Streptococcus pneumoniae / Q000187:drug effects
D000900:Anti-Bacterial Agents; D007769:Lactams; D018942:Macrolides; D010406:Penicillins