入院治療を要した乳幼児の難治性中耳炎の検討
1990年から2000年-とくに最近の動向について
2002 年 12 巻 3 号 p. 160-165
詳細
2002 年 12 巻 3 号 p. 160-165
In this study, we performed clinical investigations for seventy-nine young patients affected with intractable otitis media including those who had otitis media as a complication from 1990 to 2000.
The subjects were 44 males and 35 females of the age from 3 months to 4 years and 3 months. The mean age was one year and two months. Of approximately 80% of the patients, the isolated bacteria from ear discharge were Haemophilus influenzae, Streptococcus pneumoniae or both. The number of young patients with intractable otitis media caused by H. influenzae who were required hospitalization has been increasing since 1999. Since the appearance of antibiotic-resistant H. influenzae (BLNAR) in 2000, therapy for otitis media has been more difficult.
In addition, Streptococcus pneumoniae were found to acquire the stronger resistance against antibiotics in 2000 than in 1999.
Although we have challenged intravenous administration of ABPC, SBT/ABPC, and CTRX to the patients with otitis media caused by H. influenzae and, of CTRX and MEPM to the patients with otitis media caused by BLNAR, therapeutic results are not yet satisfactory. Intravenous administration of PAPM/BP, however, was quite effective in treatment for otitis media caused by penicillin-resistant S. pneumoniae.
In nine of the 21 young patients to whom IgG2 levels were investigated in 2000, low levels of IgG 2 were detected. Globulin supplement therapy appeared to be effective in such cases. The ventilation tube in the middle ear was effective in treatment for recurrent otitis media resulting from secretory otitis media.
