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Clindamycin in treatment of chronic recurrent suppurative otitis media in children

Published online by Cambridge University Press:  29 June 2007

Itzhak Brook
Itzhak Brook
Affiliation:
Reprint address: I.Brook, M.Sc., M.D., Assistant Professor of Child Health and Development, George Washington University Medical School, Clinical Microbiology Laboratory and Infectious Diseases, Children's Hospital National Medical Center, 111 Michigan Avenue, N.W., Washington, D.C. 20010.
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Abstract

Tympanocentesis was performed in 28 pediatric patients with chronic recurrent suppurative otitis media. The purulent aspirate was cultured aerobically and anaerobically. Aerobes only were isolated from 4(14·3 per cent) patients; five (17·9 per cent) had only anaerobes and 19 (67·8 per cent) had both aerobes and anaerobes. There were 36 aerobic isolates. P. aeruginosa was recovered in 16 patients. Other aerobes commonly recovered included Proteus sp. and S. aureus. There were 38 anaerobes isolated. Anaerobic Gram-positive cocci were isolated in 23 instances. Eleven Bacteroides sp. were recovered, including 4 B. fragilis group and 5 B. melaninogenicus. All of the patients were treated with clindamycin in a dose of 30 to 40 mg per kilogram per day divided into 3 dosages for a total period of 14 to 21 days (average 17 days). When Gram-negative enteric aerobic rods were also recovered in substantial numbers, an aminoglycoside (gentamicin) was added to the therapy (in 12 patients) and administered parenterally for 7 to 10 days. The patients' response to the therapy was excellent in 7 cases, good in 9, fair in 3 and poor in 9. There were no diarrhea episodes or colitis noted and there were no other sideeffects due to the therapy. The above findings demonstrate the polymicrobial etiology of chronic recurrent suppurative otitis media and suggest that medical treatment directed against the aerobic and anaerobic bacteria isolated from the patients' ear aspirates could eradicate the infection completely in more than half of the cases.

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 94 , Issue 6 , June 1980 , pp. 607 - 615
Copyright
Copyright © JLO (1984) Limited 1980

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References

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