Journal Article

Effects of Amoxicillin/Clavulanate or Azithromycin on Nasopharyngeal Carriage of <i>Streptococcus pneumoniae</i> and <i>Haemophilus influenzae</i> in Children with Acute Otitis Media

Faryal Ghaffar, Luz Stella Muniz, Kathy Katz, Jason Reynolds, Jeanette L. Smith, Phyllis Davis, Ian R. Friedland and George H. McCracken

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 4, pages 875-880
Published in print October 2000 | ISSN: 1058-4838
Published online October 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318160
Effects of Amoxicillin/Clavulanate or Azithromycin on Nasopharyngeal Carriage of Streptococcus pneumoniae and Haemophilus influenzae in Children with Acute Otitis Media

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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.

Journal Article.  3987 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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