Pediatric Infection: Otitis Media Therapy and Drug Resistance Part 2: Current Concepts and New Directions

Eugene Leibovitz, MD, Ron Dagan, MD, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Infect Med. 2001;18(5) 

In This Article

Abstract and Introduction

Acute otitis media (AOM) is the most common illness that requires a visit to a physician in the developed world, and the number of cases has increased substantially in the past 2 decades. This same period has been marked by a significant increase in drug resistance among pathogens that cause AOM. We provide an evaluation of the agents used to control infections with these pathogens. Prophylactic modalities are also discussed. Advent of the Streptococcus pneumoniae polysaccharide conjugate vaccine, coupled with more judicious use of antibiotics, will improve management of AOM in the coming years.

In Part 1 of this article (Infect Med. 2001;18:212-216), we presented an overview of drug resistance in acute otitis media (AOM), described specific pathogens and the pharmacokinetics/pharmacodynamics of specific antibiotic agents, and outlined the correlation between antibiotic resistance and clinical/bacteriologic outcome. In this second part of the article, we discuss nasopharyngeal colonization in AOM, provide an in-depth analysis of drug resistance linked to various anti-AOM agents, and describe current methods of chemoprophylaxis and immunoprophylaxis.


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