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Effects of amoxicillin/clavulanate or azithromycin on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media.
Clin Infect Dis. 2000 Oct; 31(4):875-80.CI

Abstract

The effect of antibiotic therapy on nasopharyngeal colonization by Streptococcus pneumoniae and Haemophilus influenzae was evaluated in children diagnosed with acute otitis media. Children were randomly assigned to receive either amoxicillin/clavulanate or azithromycin therapy, and nasopharyngeal swabs were obtained for culture before and after starting therapy. Amoxicillin/clavulanate therapy eradicated or suppressed all strains of S. pneumoniae susceptible to penicillin, 75% of strains with intermediate resistance, and 40% of strains resistant to penicillin. Azithromycin therapy cleared two-thirds of azithromycin-susceptible strains of S. pneumoniae but none of azithromycin-nonsusceptible strains. Selection for antibiotic-resistant strains in individual children was not observed in children who received amoxicillin/clavulanate therapy but was observed in 2 children who received azithromycin therapy. Carriage of H. influenzae was also reduced by antimicrobial therapy but more so by amoxicillin/clavulanate. Antibiotic therapy does not directly increase the number of resistant strains in the population but, by eradicating susceptible strains, allows greater opportunity for carriage and spread of resistant strains.

Authors+Show Affiliations

Dept. of Pediatrics, Division of Infectious Disease, University of Texas Southwestern Medical Center, Dallas, TX 75235-9063, USA. fghaff@mednet.swmed.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11049764

Citation

Ghaffar, F, et al. "Effects of Amoxicillin/clavulanate or Azithromycin On Nasopharyngeal Carriage of Streptococcus Pneumoniae and Haemophilus Influenzae in Children With Acute Otitis Media." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 31, no. 4, 2000, pp. 875-80.
Ghaffar F, Muniz LS, Katz K, et al. Effects of amoxicillin/clavulanate or azithromycin on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media. Clin Infect Dis. 2000;31(4):875-80.
Ghaffar, F., Muniz, L. S., Katz, K., Reynolds, J., Smith, J. L., Davis, P., Friedland, I. R., & McCracken, G. H. (2000). Effects of amoxicillin/clavulanate or azithromycin on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 31(4), 875-80.
Ghaffar F, et al. Effects of Amoxicillin/clavulanate or Azithromycin On Nasopharyngeal Carriage of Streptococcus Pneumoniae and Haemophilus Influenzae in Children With Acute Otitis Media. Clin Infect Dis. 2000;31(4):875-80. PubMed PMID: 11049764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of amoxicillin/clavulanate or azithromycin on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media. AU - Ghaffar,F, AU - Muniz,L S, AU - Katz,K, AU - Reynolds,J, AU - Smith,J L, AU - Davis,P, AU - Friedland,I R, AU - McCracken,G H,Jr Y1 - 2000/10/25/ PY - 1999/12/28/received PY - 2000/10/26/pubmed PY - 2001/3/3/medline PY - 2000/10/26/entrez SP - 875 EP - 80 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 31 IS - 4 N2 - The effect of antibiotic therapy on nasopharyngeal colonization by Streptococcus pneumoniae and Haemophilus influenzae was evaluated in children diagnosed with acute otitis media. Children were randomly assigned to receive either amoxicillin/clavulanate or azithromycin therapy, and nasopharyngeal swabs were obtained for culture before and after starting therapy. Amoxicillin/clavulanate therapy eradicated or suppressed all strains of S. pneumoniae susceptible to penicillin, 75% of strains with intermediate resistance, and 40% of strains resistant to penicillin. Azithromycin therapy cleared two-thirds of azithromycin-susceptible strains of S. pneumoniae but none of azithromycin-nonsusceptible strains. Selection for antibiotic-resistant strains in individual children was not observed in children who received amoxicillin/clavulanate therapy but was observed in 2 children who received azithromycin therapy. Carriage of H. influenzae was also reduced by antimicrobial therapy but more so by amoxicillin/clavulanate. Antibiotic therapy does not directly increase the number of resistant strains in the population but, by eradicating susceptible strains, allows greater opportunity for carriage and spread of resistant strains. SN - 1058-4838 UR - https://www.unboundmedicine.com/medline/citation/11049764/Effects_of_amoxicillin/clavulanate_or_azithromycin_on_nasopharyngeal_carriage_of_Streptococcus_pneumoniae_and_Haemophilus_influenzae_in_children_with_acute_otitis_media_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/318160 DB - PRIME DP - Unbound Medicine ER -