Linked Life Data

11688595

Source:http://linkedlifedata.com/resource/pubmed/id/11688595

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2001-11-1
pubmed:abstractText
Treatment of acute otitis media (AOM) is the leading cause of antibacterial use in children in most developed countries. Rates of Streptococcus pneumoniae strains resistant to many classes of antibacterial agents have risen dramatically in many countries over the past 20 years. While more restricted use of antibacterial agents for AOM would almost certainly slow the rise in resistance, AOM is a potentially painful disease and may have suppurative complications such as mastoiditis. In this review, we discuss the prudent use of antibacterial agents for AOM and provide an overview of the epidemiology of S. pneumoniae resistance worldwide. Data from 10 placebo-controlled studies in patients with AOM show that antibacterial treatment is generally associated with a significantly higher cure rate than placebo. Of the three studies which analysed children <2 years of age, cure rates were 28 to 48% for placebo and 41 to 74% with antibacterial agents. Of the studies purporting to show no difference in cure rates between placebo and antibacterial therapy, the diagnostic criteria defining entry into the study were poor; therefore, the studies may have included many children without bacterial disease. Accurate diagnosis of AOM is the key element in reducing unnecessary antibacterial usage. Either pneumatic otoscopy or tympanometry can provide evidence of an effusion and the presence of an opaque, yellow or creamy white bulging eardrum will confirm AOM. Finally, the selection of appropriate antibacterial agents will reduce the rise in resistance. Low dosages of antibacterial agents used for prophylaxis select for resistance, and certain classes of drugs such as the sulfonamides and macrolides appear to do the same even at therapeutic doses. Amoxicillin at high dosages should remain the first-line antibacterial agent. In the future, use of vaccination strategies against pneumococci, influenza, respiratory syncytial virus and non-typeable Haemophilus influenzae will also decrease antibacterial use.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1174-5878
pubmed:author
pubmed:issnType
Print
pubmed:volume
3
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
639-47
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed:year
2001
pubmed:articleTitle
The role of antibacterial therapy of acute otitis media in promoting drug resistance.
pubmed:affiliation
The Children's Hospital and University of Colorado School of Medicine, Denver 80218, USA. johnson.candice@tchden.org
pubmed:publicationType
Journal Article, Review, Research Support, Non-U.S. Gov't