急性中耳炎に対するＣＤＴＲ‐ＰＩ増量投与の検討

Abstract

Recently, a rapid increase in penicillin resistant pneumococci has been reported in most areas of the world. These penicillin resistant bacteria are becoming less susceptible to other commonly prescribed oral antimicrobial drugs, including extended-spectrum cephalosporins. Also, a rapid spread of ampicillin resistant Heamophilus influenzae in children with respiratory tract infections has been reported in Japan. Therefore, we carried out clinical and bacteriological studies on double quantities of cefditoren (CDTR) in patients with pediatric acute otitis media at 5 general hospitals.Between February 1999 and May 1999, 118 strains of Streptococcus pneumoniae and 70 strains of Haemophilus influenzae were isolated from the nasopharynx in 144 children with acute otitis media. Of the 118 Streptococcus pneumoniae, penicillin G resistant S. pneumoniae (PRSP) and penicillin G intermediately resistant S. pneumoniae (PISP) accounted for 29% and 43%, respectively. On the other hand, of the 70 Haemophilus influenzae, the number of j3-lactamase-negative ampicillinresistant (BLNAR) strains was 24%.The bacteriological efficacy of double quantities of CDTR in patients with PRSP, PISP and BLNAR was 20%, 43% and 63%, and the clinical efficacy of CDTR was 65%, 79% and 75%, respectively. These results suggest that the sterilization of pediatric nasopharynxes using oral antimicrobial drugs is difficult, but CDTR is a useful oral antibiotic for clinically acute pediatric otitis media.