ISSN: 1305-3876
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Bacteriology And Treatment Of Otitis Media
Dr. Oğuz BASUTa
aKBB AD, Uludağ Üniversitesi Tıp Fakültesi, BURSA
Even though viruses have some role in the pathogenesis (especially by the way of viral upper respiratory tract infections), otitis media usually is a bacterial disease. The causative bacteria may be the members of normal upper respiratory tract or their source may be somewhere else. Every clinical picture has a different bacteriologic profile. Knowledge about these profiles helps us to choose between different empirical antibiotic treatment options.
The majority of the bacteria playing a role in the etiology of acute otitis media are S. pneumoniae, H. influenzae and M. catarrhalis. But no bacteria can be recovered in a significant proportion of the middle ear aspirates. The first line antibiotic is usually Amoxicillin (40-80 mg/kg/day) in the empiric treatment of this disease. Besides, co-trimoxasole, erithromycin, amoxicillin+clavulanate, ampicillin+sulbactam, azithromycin, clarithromycin, cefaclor, cefprozil, cefixime, ceftriaxone, cefuroxime axetil are the other antibiotics which are frequently prescribed. There is a general tendency towards continuation of the treatment for ten days.
The same microorganisms take part in the course of Otitis Media with Effusion. Though otitis media with effusion is treated with almost the same antibiotics, the critical point is to give the antibiotic treatment for only once with appropriate duration and dosage rather than repeated treatments.
The bacteriologic profile of chronic suppurative otitis media is completely different and the dominant bacteria recovered from the cultures are Pseudomonas aeruginosa, Staphylococcus aureus, Proteus species, gram negative enteric bacilli and anaerobes. Treatment consists of topical antibiotic solutions and local care rather than systemic antibiotics. It is well known that topical quinolons are one of the most effective treatment options.Keywords: Acute otitis media, otitis media with effusion, chronic suppurative otitis media, bacteriology, antibiotic treatmentTurkiye Klinikleri J Surg Med Sci 2005, 1(7):20-25
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