Recently, penicillin resistantStreptococcus pneumoniae (PRSP) and β-lactamase-negative ampicillinresistantHaemophilus influenzae (BLNAR) have been increased among children with acute otitis media. These resistant bacteria were becoming less susceptible to commonly prescribed oral antibacterial drugs. We studied clinical effect and utility of surgical management that bacteria were isolated 91 patients with acute otitis media between April 2001 and March 2002. In addition, we investigated the effectiveness of cefditoren pivoxil (CDTR) for three major bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) in all bacteria isolated from the outpatients with acute otitis media. InHaemophilus influenzae, especially, we conducted gene level studies using PCR to identify resistant gene.
The clinical effect on all bacteria was 72.5%.
Myringotomy was effective more than conservative treatment for acute otitis media. Three major bacteria wereStreptococcus pneumoniae (30 strains, 30%), Haemophilus influenzae (24 strains, 24%) andMoraxella catarrhalis (7 strains, 9%). The Streptococcus pneumoniae strains included PSSP 16 (53%), PISP 10 (33%), and PRSP 4 (13%). TheHaemophilus influenzaestrains included BLNAS 9 (38%), Low-BLNAR 13 (54%), and BLNAR 2 (8%). The clinical effects of CDTR in patients with PSSP, PISP, and PRSP was 67%, 80%, and 100%. The clinical effects of CDTR in patients with BLNAS, Low-BLNAR and BLNAR was 100%, 77%, and 50%.