All issues > Volume 46(5); 2003

Original Article

J Korean Pediatr Soc. 2003;46(5):459-466. Published online May 15, 2003.

Causative Pathogens and Therapeutic Assessment of Cefprozil in Acute Otitis Media

Jin-Han JH Kang¹, Jong Hyun JH Kim¹, Yong-Soo YS Park², Young-Chul YC Choi², Heil HI Noh², Hoon Shik HS Yang³, Kyu Sung KS Kim⁴, Yeon Sook YS Moon⁵, Young Jin YJ Hong⁶

¹Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
²Department of Otolaryngology, College of Medicine, The Catholic University of Korea, Korea
³Department of Otolaryngology, College of Medicine, Chung-Ang University, Seoul, Korea
⁴Department of Otolaryngology, College of Medicine, Inha University, Incheon, Korea
⁵Department of Clinical Pathology, College of Medicine, Inha University, Incheon, Korea
⁶Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea

Correspondence Jin-Han JH Kang ,Email: kjhan@olmh.cuk.ac.kr

Abstract

Purpose
: AOM is the most common bacterial URI in children. The bacteriology and antibiotic Tx of AOM in children has been studied in many countries. But, there is few study of causative pathogens and antibiotic Tx of AOM in our country. In this aspect, we performed prospective clinical study to confirm the causative pathogens and assess the clinical responses of cefprozil in AOM patients.
Methods
: Thirty three AOM patients enrolled in this study. Tympanocentesis for isolation of causative pathogens were performed before Tx of cefprozil. The study patients received cefprozil with dose of 15 mg/kg/bid.po/day for 10-12 days, and initially assessed the clinical response at 4-5 days after receiving cefprozil and finally at the end visit. In vitro susceptibility tests of cefprozil to isolated pathogens were done by disc diffusion method, and in vitro susceptibility tests of cefaclor and cefixime to isolated pathogens were simultaneously performed.
Results
: Bacterial pathogens[S. pneumoniae(10), H. influenzae(5), S. aureus(2), M. catarrhalis(1) and Group A stretococcus(1)] were isolated from 19 patients. Clinically, all patients had history of abrupt high fever except one. Tympanic perforation was dominant in pathogens isolated cases, and otalgia was significantly developed in non-pathogens isolated cases. The ages of pathogens isolated cases were usually below 2 years. Eighty four point nine percent of the patients including two cases with isolation of intermediate resistant S. pneumoniae were clinically improved. Antimicrobial in vitro activity to S. pneumoniae of cefprozil were superior than that of cefacor and cefixime.
Conclusion
: We confirm that bacteria has the causative role in about 60% cases, and S. pneumoniae is the most common pathogen. Clinically, there were some differences in symptoms, signs and ages between pathogens isolated and non-pathogens isolated cases. The clinical responses of cefprozil in our patients revealed similar outcomes to other countries. And we reconfirm that cefprozil may be clinically effective in cases of AOM due to intermediate resistant S. pneumoniae.

Keywords :Acute otitis media(AOM), Causative pathogens, Cefprozil