מתוך medicontext.co.il
NEW YORK (Reuters Health) – Streptococcus pneumoniae and Haemophilus influenzae are the most commonly recovered organisms after an aminopenicillin has been used to treat acute otitis media, according to a recent report.
The current findings contradict the widely held belief that beta-lactamase-producing organisms are the predominant pathogen after amoxicillin failure. Equally surprising is that H. influenzae is the predominant organism after treatment with amoxicillin/clavulanate (AMC) rather than pencillin-nonsusceptible S. pneumoniae.
Dr. Stan L. Block, from Kentucky Pediatric Research in Louisville, Kentucky and colleagues evaluated the pathogens obtained from 90 children after treatment for acute otitis media with an aminopenicillin. Of the 96 pathogens recovered, 38 came from children treated with amoxicillin and 58 from children treated with AMC.
Among amoxicillin-treated children, S. pneumoniae was the predominant pathogen, accounting for 59% of pathogens. Beta-lactamase-positive organisms only comprised 24% of pathogens.
The most common pathogen among children treated with AMC was H. influenzae, accounting for 51% of pathogens, the authors note. Pencillin-nonsusceptible S. pneumoniae accounted for 27% of the pathogens isolated.
Children recently treated with amoxicillin were significantly less likely to be otitis prone than AMC-treated children (p < 0.0001), the researchers note in the November issue of the Pediatric Infectious Disease Journal.
The current findings suggest that physicians should not disregard S. pneumoniae as a potential pathogen when children fail amoxicillin therapy, the investigators emphasize. In addition, the results suggest that H. influenzae should be the primary target in children who fail AMC.
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