小児耐性肺炎球菌性急性中耳炎の治療

Abstract

The increase of infant cases of acute otitis media caused by penicillin resistant Streptococcus pneumoniae (PRSP) presents a formidable problem and has, in resent years, both hampered and prolonged medical treatment. From March 2001 to March 2002, we enforced a bacteriological examination aimed at germs of nasopharyngeal origin in an effort to identify the pathogen responsible for 292 cases of acute otitis media at our hospital. The detection frequency of PRSP was 93/292 (31.8%). The age of the patients ranged from three months to 61 years and 85 (91.4%) were infants. In 70 of these 85 cases, we were able to achieve a good outcome. In this series, we examined the treatment progress in these 70 infant cases.In 27 of these 70 cases (38.6%), PRSP was detected alone. The simultaneously detected bacteria types were Haemophilus Influenzae (H. I) in 24 cases (34.3%), Moraxella Catarrhalis (M. C) in 8 cases (11.4%) and H. I+M. C in 7 cases (10.0%).Although gender, the existence of mixed infections and the kind of antibiotics initially prescribed were not found to have had a significant effect on the outcome, both age and the existence of eardrum incision did appeared to influence the duration of the therapeutic period.