Pediatria pre prax 1/2008

CHARACTERISTIC OF ACUTE OTITIS MEDIA REQUISITE HOSPITALIZATION IN LITTLE CHILDREN

Authors present the retrospective analysis of children up to 3 years of age with acute otitis media (AOM) required hospitalization. During years 2001 – 2006, 92 children were treated with this diagnosis (app. 20 children per year). More than 60 % of them were unsuccesfully treated by antibiotics before admisssion, 55% were in infant age. Laboratory tests confirmed bacterial ethiology of AOM. 14 children were found anemic, 15 children had some kind immunodeficiency (mainly dysimmunoglobulinemia), the total comorbidity was 42 % in the study group. From all bacterial cultivation swabs 46 % were negative. Streptococcus pneumoniae (SP) was the most frequent agent, in more than 60 % of positive bacteriologic tests. Only 23 % of SP strains was sensitive to penicillin, and 50 % strains were multiresistent (MRSP), sensitive only to ciprofloxacin, chloramphenicol, and tetracycline. In the treatment of these patients ciprofloxacin was used as well as empiric therapy of children with negative bacteriologic tests and not responding to another antibiotics. Despite the data in literature the effectivity and tolerance of ciprofloxacin was satisfactory. The were no differences between MRSP AOM group and other group from point of the duration of illness, hospitalization, and frequency of ENT surgical interventions. In nine children with MRSP AOM from foster home, the 23F serotype of SP was revealed. Majority of them were vaccinated after treatment using the 7-valent conjugates pneumococcal vaccine (PCV7) with excellent long- term result.

Keywords: acute otitis media, early childhood, pneumococcus, ciprofloxacin.