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Long-term effects on the nasopharyngeal flora of children following antimicrobial therapy of acute otitis media with cefdinir or amoxycillin-clavulanate.
J Med Microbiol. 2005 Jun; 54(Pt 6):553-556.JM

Abstract

The effect on the nasopharyngeal bacterial flora of 10 days of amoxycillin-clavulanate or cefdinir antimicrobial therapy was studied in 50 children with acute otitis media. Before therapy, 17 potential pathogens (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) were isolated from the nasopharynx of 14 (56%) of those treated with amoxycillin-clavulanate, and 20 potential pathogens were recovered from 15 (60%) of those treated with cefdinir. Following therapy, at days 12-15, the number of potential pathogens was reduced to a similar extent with both therapies, to three in those treated with amoxycillin-clavulanate and two in those treated with cefdinir. However, the number of potential pathogens rebounded faster in those treated with amoxycillin-clavulanate as compared with cefdinir in the two subsequent specimens taken at days 30-35 and 60-65 (12 and 18 in the amoxycillin-clavulanate group, and six and nine in the cefdinir group, P < 0.01 and P < 0.001, respectively). Differences between the groups were also noted in the recovery of organisms with interfering capability. Immediately following amoxycillin-clavulanate therapy, the number of interfering organisms declined from 54 to 13, while following cefdinir treatment their number was reduced from 59 to 39 (P < 0.001). The differences between the two therapy groups persisted in the two later specimens taken at days 30-35 and 60-65 (25 and 38 in the amoxycillin-clavulanate group, and 52 and 51 in the cefdinir group, P < 0.001 and P < 0.05, respectively). This study illustrates the potential beneficial effect of using a narrow-spectrum antimicrobial that selectively spares the interfering organisms while eliminating pathogens. The benefit of such therapy is the prevention of reacquisition of pathogenic bacteria in the nasopharynx. In contrast, utilization of a broad-spectrum antimicrobial is associated with prolonged absence of inhibitory organisms and rapid recolonization with pathogens.

Authors+Show Affiliations

Departments of Pediatrics, Georgetown University School of Medicine, 4431 Albemarle St NW, Washington DC 20016, USA.Departments of Pediatrics, Georgetown University School of Medicine, 4431 Albemarle St NW, Washington DC 20016, USA.

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

15888464

Citation

Brook, Itzhak, and Alan E. Gober. "Long-term Effects On the Nasopharyngeal Flora of Children Following Antimicrobial Therapy of Acute Otitis Media With Cefdinir or Amoxycillin-clavulanate." Journal of Medical Microbiology, vol. 54, no. Pt 6, 2005, pp. 553-556.
Brook I, Gober AE. Long-term effects on the nasopharyngeal flora of children following antimicrobial therapy of acute otitis media with cefdinir or amoxycillin-clavulanate. J Med Microbiol. 2005;54(Pt 6):553-556.
Brook, I., & Gober, A. E. (2005). Long-term effects on the nasopharyngeal flora of children following antimicrobial therapy of acute otitis media with cefdinir or amoxycillin-clavulanate. Journal of Medical Microbiology, 54(Pt 6), 553-556. https://doi.org/10.1099/jmm.0.45837-0
Brook I, Gober AE. Long-term Effects On the Nasopharyngeal Flora of Children Following Antimicrobial Therapy of Acute Otitis Media With Cefdinir or Amoxycillin-clavulanate. J Med Microbiol. 2005;54(Pt 6):553-556. PubMed PMID: 15888464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term effects on the nasopharyngeal flora of children following antimicrobial therapy of acute otitis media with cefdinir or amoxycillin-clavulanate. AU - Brook,Itzhak, AU - Gober,Alan E, PY - 2005/5/13/pubmed PY - 2005/8/2/medline PY - 2005/5/13/entrez SP - 553 EP - 556 JF - Journal of medical microbiology JO - J Med Microbiol VL - 54 IS - Pt 6 N2 - The effect on the nasopharyngeal bacterial flora of 10 days of amoxycillin-clavulanate or cefdinir antimicrobial therapy was studied in 50 children with acute otitis media. Before therapy, 17 potential pathogens (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) were isolated from the nasopharynx of 14 (56%) of those treated with amoxycillin-clavulanate, and 20 potential pathogens were recovered from 15 (60%) of those treated with cefdinir. Following therapy, at days 12-15, the number of potential pathogens was reduced to a similar extent with both therapies, to three in those treated with amoxycillin-clavulanate and two in those treated with cefdinir. However, the number of potential pathogens rebounded faster in those treated with amoxycillin-clavulanate as compared with cefdinir in the two subsequent specimens taken at days 30-35 and 60-65 (12 and 18 in the amoxycillin-clavulanate group, and six and nine in the cefdinir group, P < 0.01 and P < 0.001, respectively). Differences between the groups were also noted in the recovery of organisms with interfering capability. Immediately following amoxycillin-clavulanate therapy, the number of interfering organisms declined from 54 to 13, while following cefdinir treatment their number was reduced from 59 to 39 (P < 0.001). The differences between the two therapy groups persisted in the two later specimens taken at days 30-35 and 60-65 (25 and 38 in the amoxycillin-clavulanate group, and 52 and 51 in the cefdinir group, P < 0.001 and P < 0.05, respectively). This study illustrates the potential beneficial effect of using a narrow-spectrum antimicrobial that selectively spares the interfering organisms while eliminating pathogens. The benefit of such therapy is the prevention of reacquisition of pathogenic bacteria in the nasopharynx. In contrast, utilization of a broad-spectrum antimicrobial is associated with prolonged absence of inhibitory organisms and rapid recolonization with pathogens. SN - 0022-2615 UR - https://www.unboundmedicine.com/medline/citation/15888464/Long_term_effects_on_the_nasopharyngeal_flora_of_children_following_antimicrobial_therapy_of_acute_otitis_media_with_cefdinir_or_amoxycillin_clavulanate_ L2 - http://jmm.microbiologyresearch.org/pubmed/content/journal/jmm/10.1099/jmm.0.45837-0 DB - PRIME DP - Unbound Medicine ER -