zithromax and Otitis-Media--Suppurative

In an open-label study, the concentrations of azithromycin in middle ear effusions and plasma were determined in 29 children between 1 and 8 years of age with a diagnosis of either secretory otitis media of at least 1 month's duration or acute otitis media. Azithromycin (10 mg/kg) was administered as a single dose 12, 24 or 48 h before the insertion of tympanostomy tubes to 17 children with secretory otitis media and once daily for 5 days (10 mg/kg on day 1, 5 mg/kg on days 2-5) to 12 children with acute otitis media. In the 16 evaluable patients with secretory otitis media, azithromycin penetrated middle ear effusions, with group mean concentrations approximately two orders of magnitude greater than the concurrent plasma concentrations 12, 24 and 48 h after administration. Similar plasma:effusion ratios were found 24 and 48 h after starting once-daily therapy in 10 evaluable patients with acute otitis media.

Topics: Acute Disease; Anti-Bacterial Agents; Azithromycin; Child; Child, Preschool; Ear, Middle; Female; Humans; Infant; Male; Otitis Media with Effusion; Otitis Media, Suppurative

Acute otitis media (AOM) is one of the most common diseases of childhood. Knowledge, of which bacteria are the most common pathogens in AOM and their susceptibilities towards antibiotics, is essential for the reasonable empiric treatment. With rapidly increasing frequencies of antibiotic resistance surveillance of the common etiologic pathogens has become pertinent. The purpose of this paper is to present the bacteriological findings and antibiotic susceptibilities, in cultures from nasopharyngeal swabs, in Danish children with AOM.. Children aged up to 10 years who had AOM diagnosed in general practice in Denmark were swabbed in nasopharynx, cultures were incubated and susceptibility testing was performed as tablet diffusion and minimal inhibitory concentrations (MICs) were determined by E-test.. We included 331 patients, in 257 bacteria were found, which could be classified as commonly ear pathogenic. The most frequent bacteria found was Streptococcus pneumoniae followed by Haemophilus influenzae and Moraxella catarrhalis. Ninety-six percent of the tested S. pneumoniae were susceptible towards penicillin and 99% towards erythromycin. Eighty-nine percent of the H. influenzae were susceptible to ampicillin and all tested M. catarrhalis were susceptible towards erythromycin. In more than 30% of H. influenzae MIC of phenoxymethylpenicillin were above the level that could be achieved in middle ear fluid.. Antimicrobial resistance is still infrequent in pathogens that might cause AOM in children in Denmark; this is probably due to minimal use of antibiotics as well as the use of phenoxymethylpenicillin as primary drug for treatment of AOM. Phenoxymethylpenicillin and azithromycin are not efficient for treating the majority of infections due to H. influenzae.

Topics: Acute Disease; Anti-Bacterial Agents; Azithromycin; Bacterial Infections; Child; Child, Preschool; Denmark; Drug Utilization; Female; Humans; Infant; Male; Nasopharynx; Otitis Media, Suppurative; Penicillin V

We report the case of a 9 years old child diagnosed as right otitis media with effusion associated to homolateral and peripherical facial palsy, fact very uncommon in the reviewed literature. The patient was treated by miringotomy and insertion of transtympanic drainage recovering his facial function totally after 9 weeks.

Topics: Anti-Bacterial Agents; Audiometry, Pure-Tone; Azithromycin; Child; Facial Paralysis; Hearing Loss, Conductive; Humans; Male; Otitis Media, Suppurative; Severity of Illness Index