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The effects of treatment of acute otitis media with a low dose vs a high dose of amoxicillin on the nasopharyngeal flora.
Arch Otolaryngol Head Neck Surg. 2009 May; 135(5):458-61.AO

Abstract

OBJECTIVE

To compare the effects on the nasopharyngeal flora of therapy of acute otitis media in children with either a low dose or a high dose of amoxicillin.

DESIGN

Retrospective study.

PATIENTS

Of 50 children diagnosed as having acute otitis media, 25 received a low dose of amoxicillin (45 mg/kg/d) (group 1) and 25 received a high dose of amoxicillin (90 mg/kg/d) (group 2) for 10 days, and both groups were evaluated.

INTERVENTION

Antimicrobial treatment.

RESULTS

Before therapy, potential pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus) were isolated from the nasopharynx of 15 children in group 1 (60%) and 13 in group 2 (52%). The number of penicillin-susceptible isolates was equally reduced after both therapies. However, an increase was noted in the recovery of S aureus only in group 2 (from 2 to 6 organisms). A greater eradication rate of interfering organisms following therapy was noted in group 2 (from 86 to 36) than in group 1 (from 92 to 60) (P < .001). These organisms include alpha-hemolytic streptococci, and Peptostreptococcus and Prevotella species.

CONCLUSIONS

The oral flora at the end of therapy with a high dose of amoxicillin is more depleted of organisms with interfering capability than following treatment with a low dose of amoxicillin. These changes may contribute to the greater recovery rate of patients infected with S aureus who received a high dose of amoxicillin.

Authors+Show Affiliations

Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA. ib6@georgetown.eduNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19451466

Citation

Brook, Itzhak, and Alan E. Gober. "The Effects of Treatment of Acute Otitis Media With a Low Dose Vs a High Dose of Amoxicillin On the Nasopharyngeal Flora." Archives of Otolaryngology--head & Neck Surgery, vol. 135, no. 5, 2009, pp. 458-61.
Brook I, Gober AE. The effects of treatment of acute otitis media with a low dose vs a high dose of amoxicillin on the nasopharyngeal flora. Arch Otolaryngol Head Neck Surg. 2009;135(5):458-61.
Brook, I., & Gober, A. E. (2009). The effects of treatment of acute otitis media with a low dose vs a high dose of amoxicillin on the nasopharyngeal flora. Archives of Otolaryngology--head & Neck Surgery, 135(5), 458-61. https://doi.org/10.1001/archoto.2008.506
Brook I, Gober AE. The Effects of Treatment of Acute Otitis Media With a Low Dose Vs a High Dose of Amoxicillin On the Nasopharyngeal Flora. Arch Otolaryngol Head Neck Surg. 2009;135(5):458-61. PubMed PMID: 19451466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of treatment of acute otitis media with a low dose vs a high dose of amoxicillin on the nasopharyngeal flora. AU - Brook,Itzhak, AU - Gober,Alan E, PY - 2009/5/20/entrez PY - 2009/5/20/pubmed PY - 2009/6/6/medline SP - 458 EP - 61 JF - Archives of otolaryngology--head & neck surgery JO - Arch Otolaryngol Head Neck Surg VL - 135 IS - 5 N2 - OBJECTIVE: To compare the effects on the nasopharyngeal flora of therapy of acute otitis media in children with either a low dose or a high dose of amoxicillin. DESIGN: Retrospective study. PATIENTS: Of 50 children diagnosed as having acute otitis media, 25 received a low dose of amoxicillin (45 mg/kg/d) (group 1) and 25 received a high dose of amoxicillin (90 mg/kg/d) (group 2) for 10 days, and both groups were evaluated. INTERVENTION: Antimicrobial treatment. RESULTS: Before therapy, potential pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus) were isolated from the nasopharynx of 15 children in group 1 (60%) and 13 in group 2 (52%). The number of penicillin-susceptible isolates was equally reduced after both therapies. However, an increase was noted in the recovery of S aureus only in group 2 (from 2 to 6 organisms). A greater eradication rate of interfering organisms following therapy was noted in group 2 (from 86 to 36) than in group 1 (from 92 to 60) (P < .001). These organisms include alpha-hemolytic streptococci, and Peptostreptococcus and Prevotella species. CONCLUSIONS: The oral flora at the end of therapy with a high dose of amoxicillin is more depleted of organisms with interfering capability than following treatment with a low dose of amoxicillin. These changes may contribute to the greater recovery rate of patients infected with S aureus who received a high dose of amoxicillin. SN - 1538-361X UR - https://www.unboundmedicine.com/medline/citation/19451466/The_effects_of_treatment_of_acute_otitis_media_with_a_low_dose_vs_a_high_dose_of_amoxicillin_on_the_nasopharyngeal_flora_ L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/archoto.2008.506 DB - PRIME DP - Unbound Medicine ER -