Abstract | INTRODUCTION: METHODS: Of the 704 rural Kentucky children with culture-positive AOM who underwent a single tympanocentesis or culture of otorrhea between 1992 and 1998, 96 pathogens were recovered from 90 children during therapy or within 7 days posttherapy with an aminopenicillin. Identification and susceptibility testing of AOM pathogens were performed by routine National Committee for Clinical Laboratory Standards methods. RESULTS: Pathogens recovered from children with AOM recently treated (0 to 7 days) with amoxicillin (n = 38) and AMC (n = 58), respectively, were as follows: Haemophilus influenzae ( beta-lactamase-negative), 16 and 29%; H. influenzae ( beta-lactamase-positive), 11 and 22%; penicillin-susceptible Streptococcus pneumoniae, 26 and 12%; intermediately penicillin-nonsusceptible S. pneumoniae (PNSP), 20 and 10%; resistant PNSP 13 and 17%; Moraxella catarrhalis ( beta-lactamase-positive), 13 and 7%; and Streptococcus pyogenes, 3 and 2%. H. influenzae was also isolated from 8 (75%) of 12 children treated with high dose AMC ( approximately 80 mg/kg/day amoxicillin component). Significantly fewer children recently treated with amoxicillin were otitis-prone than those given AMC (24% vs. 74%, P < 0.0001). CONCLUSIONS: The predominant pathogen recovered from children with AOM recently treated with amoxicillin was S. pneumoniae (59%) rather than beta-lactamase-producing organisms (24%). H. influenzae was the predominant (51%) pathogen, rather than PNSP (27%), recovered from children recently treated with AMC.
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Authors | S L Block, J A Hedrick, R D Tyler, R A Smith, C J Harrison |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 20
Issue 11
Pg. 1017-21
(Nov 2001)
ISSN: 0891-3668 [Print] United States |
PMID | 11734704
(Publication Type: Journal Article)
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Chemical References |
- Penicillins
- Amoxicillin-Potassium Clavulanate Combination
- Amoxicillin
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Topics |
- Acute Disease
- Adolescent
- Amoxicillin
(pharmacology, therapeutic use)
- Amoxicillin-Potassium Clavulanate Combination
(pharmacology, therapeutic use)
- Bacterial Infections
(drug therapy, microbiology)
- Child
- Child, Preschool
- Drug Resistance, Multiple, Bacterial
- Drug Therapy, Combination
(pharmacology, therapeutic use)
- Female
- Haemophilus influenzae
(drug effects, pathogenicity)
- Humans
- Infant
- Male
- Microbial Sensitivity Tests
- Moraxella catarrhalis
(drug effects, pathogenicity)
- Otitis Media with Effusion
(drug therapy, microbiology)
- Penicillins
(pharmacology, therapeutic use)
- Retrospective Studies
- Streptococcus pneumoniae
(drug effects, pathogenicity)
- Streptococcus pyogenes
(drug effects, pathogenicity)
- beta-Lactam Resistance
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