The number of patients receiving parenteral
antibiotic therapy outside the hospital (OPAT) is growing rapidly, not only because of financial considerations, but also to limit the risk of
nosocomial infections, hospitalization
trauma, and to improve the quality of life. The same benefits of OPAT have recently been extended to pediatric patients. In the present study, the efficacy and safety of OPAT was evaluated in 52 children (age range 6-12 years) affected by chronic
suppurative otitis media (CSOM) whose parents were deemed compliant. Otorhinolaryngologists and
infectious disease specialists (IDS) cooperated in diagnosing, managing patients and being available 24 hours a day for family consultation. Bacteriological examination of ear exudate was carried out before
antibiotic treatment. For all 52 children the
infection was caused by Pseudomonas aeruginosa in vitro sensitive to
ceftazidime.
Ceftazidime was administered at the dosage of 500 mg b.i.d. i.m. at the patient's home according to a
self administration model for 7-10 days. All patients returned every other day during the treatment course for clinical observation and cleansing of the ear, and 30 days after the end of the treatment (follow-up). Complete clinical cure and bacteriological eradication were observed in 35 patients (67%), clinical improvement in 12 (23%). No side-effects or
hearing impairment were reported at clinical and audiometric check-ups; compliance was absolute. Our data suggest that children affected by CSOM can be managed as outpatients by a cooperative team of otorhinolaryngologists and IDS.