Document Detail

Antibiotic treatment in acute Otitis Media promotes superinfection with resistant Streptococcus pneumoniae carried before initiation of treatment.
MedLine Citation:
PMID:  11237804     Owner:  NLM     Status:  MEDLINE    
Antibiotic-resistant pneumococci are difficult to eradicate from middle ear fluid (MEF) and the nasopharynx (NP). Bacteriologic eradication from the NP and MEF during acute otitis media (AOM) by 3 common antibiotic drugs was prospectively evaluated. In 19 (16%) of 119 MEF culture-positive patients, an organism susceptible to the treatment drug (Haemophilus influenzae, Streptococcus pneumoniae, or both) was isolated from the initial MEF, whereas resistant S. pneumoniae was present in the NP; in 9 (47%) patients, the initial resistant NP organism (identified by serotyping, resistance to the administered drug, and pulsed-field gel electrophoresis) replaced the susceptible MEF organism within only a few days after initiation of treatment. In regions where resistant pneumococci are prevalent, antibiotics may not only fail to eradicate the organisms, but they may often induce MEF superinfection with resistant pneumococci initially carried in the NP. This is an important mechanism by which, in recently treated patients, AOM infections often become refractory to treatment.
R Dagan; E Leibovitz; G Cheletz; A Leiberman; N Porat
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2001-02-09
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  183     ISSN:  0022-1899     ISO Abbreviation:  J. Infect. Dis.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-12     Completed Date:  2001-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  880-6     Citation Subset:  AIM; IM    
Pediatric Infectious Disease Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
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MeSH Terms
Acute Disease
Amoxicillin-Potassium Clavulanate Combination / therapeutic use
Anti-Bacterial Agents / therapeutic use
Azithromycin / therapeutic use
Drug Resistance, Microbial*
Drug Therapy, Combination / therapeutic use
Ear, Middle / microbiology
Nasopharynx / microbiology
Otitis Media / drug therapy*,  microbiology
Pneumococcal Infections / drug therapy*,  microbiology
Streptococcus pneumoniae / drug effects*,  isolation & purification
Superinfection / drug therapy*,  microbiology
Time Factors
Trimethoprim-Sulfamethoxazole Combination / therapeutic use
Reg. No./Substance:
0/Anti-Bacterial Agents; 74469-00-4/Amoxicillin-Potassium Clavulanate Combination; 8064-90-2/Trimethoprim-Sulfamethoxazole Combination; 83905-01-5/Azithromycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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