title: Microbiology and choice of antimicrobial therapy for acute sinusitis complicated by subperiosteal abscess in children.
abstract: OBJECTIVE
  Review past studies of the microbiology of subperiosteal abscesses (SPOA) complicating sinusitis in children and their implications of the antimicrobials administered to treat the infection.
  
  
  METHODS
  Literature search was conducted of the Cochrane Library, EMBASE, TRIP, EMBASE, and MEDLINE databases from their inception.
  
  
  RESULTS
  The most common pathogens isolated from studies of SPOA complicating sinusitis are aerobic (Streptococcus pneumoniae, Streptococcus spp., Haemophilus spp., Eikenella corrodens), anaerobic (Peptostreptococcus, Fusobacterium, Prevotella, Porphyromonas, Bacteroides, and Veillonella spp.), and micoaerophilic streptococci (Streptococcus anginosus/Streptococcus milleri group), all members of the oropharyngeal flora. S. pneumoniae and S. aureus were more frequently recovered in children >7 years old, while polymicrobial aerobic-anaerobic flora were more often isolated from those >15 years. The introduction of pneumococcal vaccine reduced the rate of isolation of S. pneumoniae, and correlated with increase of recovery of S. aureus including methicillin resistant strains, as well as Streptococcus pyogenes and S. anginosus/milleri group.
  
  
  CONCLUSIONS
  The microbiology and consequently the treatment of respiratory infections including sinusitis and its complications has evolved over the past decades. Establishing the microbiology of SPOA by obtaining appropriate cultures for both aerobic and anaerobic bacteria are essential for proper antimicrobial selection.
authors.affiliation: Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA. Electronic address: ib6@georgetown.edu.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Brook
mesh_terms: D000038:Abscess / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D012852:Sinusitis / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute sinusitis; Anaerobic bacteria; Microbiology; Sinusitis; Staphylococcus aureus; Subperiosteal abscesses