2007 Volume 28 Issue 1 Pages 52-57
To discuss the pathogen, treatment and length of hospital stay of children with acute mastoiditis, we reviewed the cases of 19 children who were hospitalized between 1991 and 2005 at Chiba Children's Hospital. Eighteen of the children were under 4 years of age and one child was 11 years of age. Among these patients,6 children were under 12 months of age and 61% of the infant patients were under 24 months of age. S. pneumoniae was isolated from middle ear discharge or subperiost abscess in 15 of the children, GAS from one child and MRSA from the 11-year-old child. No pathogen was detected in samples obtained from the other 2 children. Of the 15 children with S. pneumoniae, PRSP and PISP were each isolated from 7 children, respectively.
Though our current first choice of antibiotics is ABPC, our earlier first choice was the intravenous administration of PAPM/BP against PRSP. However, due to concerns that PAPM/BP would be less effective against S. pneumoniae, it was replaced by ABPC, which has been proved to be truly effective. The average length of hospital stay of the 17 children, excluding 2 children, was 7.2 days. Of the 2 exclusions, one had a subperiost abscess and the other had problems with her family about leaving hospital; both stayed in hospital for 13 days. All the patients were cured without mastoidectomy.
