Affiliation:
1. Rochester, New York
2. Littleton, Colorado
3. Little Rock, Arkansas
4. Washington, DC
5. New York, New York
6. Salt Lake City, Utah
7. Los Angeles, California
Abstract
Streptococcus pneumoniae is the predominant bacterial pathogen associated with acute otitis media (AOM), causing an estimated 7 million cases annually in the United States. Bacterial resistance should be considered when selecting an antimicrobial agent for otitis media. Significant increases in drug-resistant S pneumoniae are documented worldwide, and less than 50% of S pneumoniae strains are fully susceptible to penicillin in some regions of the United States. Although amoxicillin is recommended for uncomplicated AOM, treatment guidelines should be flexible and adaptable, taking into consideration local and regional susceptibility patterns, the age of the patient, the frequency of prior infections, and the response to prior therapy. Resistant organisms are more prevalent in children younger than 2 years of age and in those who have recurrent or persistent AOM. Overdiagnosing AOM, selecting inappropriate empiric therapy, or both, leads to overuse and misuse of antibiotics and causes increased drug resistance. This article reviews persistent and recurrent AOM and discusses the pitfalls of diagnosis and the practical limitations of current treatment recommendations.
Subject
General Medicine,Otorhinolaryngology
Cited by
20 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献