Document Detail


Effects of large dosages of amoxicillin/clavulanate or azithromycin on nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, nonpneumococcal alpha-hemolytic streptococci, and Staphylococcus aureus in children with acute otitis media.
MedLine Citation:
PMID:  11981724     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Prior use of antibiotics is associated with carriage of resistant bacteria. Colonization by Streptococcus pneumoniae, Haemophilus influenzae, nonpneumococcal alpha-hemolytic streptococci (NPAHS), and Staphylococcus aureus was evaluated in children receiving antibiotic therapy for acute otitis media and in untreated, healthy control subjects. Children were randomly assigned to receive either amoxicillin/clavulanate (90 mg/kg per day) or azithromycin. Swabs were obtained before initiating therapy and again 2 weeks and 2 months after initiating therapy. We also obtained swabs from control subjects at the time of enrollment and 2 weeks and 2 months after enrollment. The decrease in the rate of carriage of S. pneumoniae and H. influenzae at 2 weeks was significant only in the amoxicillin/clavulanate group (P<.001 and P=.005, respectively). The rate of nasopharyngeal colonization with NPAHS among treated patients increased from 23% to 39% at 2 months (P=.01). This increase was similar for both treatment groups. These results suggest that the competitive balance between organisms is altered by antibiotic therapy.
Authors:
Faryal Ghaffar; Luz Stella Muniz; Kathy Katz; Jeanette L Smith; Theresa Shouse; Phyllis Davis; George H McCracken
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Publication Detail:
Type:  Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2002-04-24
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  34     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-04-30     Completed Date:  2002-05-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1301-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Infectious Disease, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA. faryal.ghaffar@utsouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Amoxicillin / administration & dosage,  therapeutic use
Azithromycin / administration & dosage,  therapeutic use
Bacterial Infections / drug therapy*,  immunology,  microbiology
Child, Preschool
Clavulanic Acid / administration & dosage,  therapeutic use
Drug Therapy, Combination / administration & dosage,  therapeutic use*
Female
Haemophilus influenzae
Humans
Infant
Infant, Newborn
Male
Nasopharyngeal Diseases / drug therapy*,  immunology,  microbiology
Otitis Media
Serotyping
Staphylococcus aureus
Streptococcus
Streptococcus pneumoniae
Chemical
Reg. No./Substance:
26787-78-0/Amoxicillin; 58001-44-8/Clavulanic Acid; 83905-01-5/Azithromycin

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


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