Fliss D M, Dagan R, Meidan N, Leiberman A
Department of Otolaryngology, Soroka University Medical Center, Beer-Sheva, Israel.
Ann Otol Rhinol Laryngol. 1992 Oct;101(10):866-9. doi: 10.1177/000348949210101011.
Medical management of chronic suppurative otitis media without cholesteatoma in children was shown recently to be efficacious. We undertook a prospective study in order to determine 1) the organisms associated with the disease and their sensitivity to various antibiotics and 2) their association with clinical variables. Pseudomonas was isolated from 84% of the patients, enteric gram-negative bacilli from 32%, Staphylococcus aureus from 20%, streptococci from 14%, and Hemophilus influenzae from 15%. Pseudomonas aeruginosa was the sole isolate in 48 of the 128 patients (38%). The sensitivity of P aeruginosa (78 isolates) was 100% (of isolates) to mezlocillin and ciprofloxacin, 99% to tobramycin and ceftazidime, 97% to piperacillin, 94% to gentamicin, and 78% to ceftriaxone. The isolated organisms and their sensitivity to antibiotics were not associated with age, sex, duration of otorrhea, or the presence of granulation tissue or polyps. We believe that our data may contribute to the appropriate choice of antibiotics when nonsurgical management of chronic suppurative otitis media without cholesteatoma is considered.
最近研究表明，儿童非胆脂瘤型慢性化脓性中耳炎的药物治疗是有效的。我们进行了一项前瞻性研究，以确定：1）与该疾病相关的微生物及其对各种抗生素的敏感性；2）它们与临床变量的关联。84%的患者分离出铜绿假单胞菌，32%分离出肠道革兰氏阴性杆菌，20%分离出金黄色葡萄球菌，14%分离出链球菌，15%分离出流感嗜血杆菌。在128例患者中的48例（38%）中，铜绿假单胞菌是唯一分离出的菌株。铜绿假单胞菌（78株分离菌）对美洛西林和环丙沙星的敏感性为100%（分离菌），对妥布霉素和头孢他啶为99%，对哌拉西林为97%，对庆大霉素为94%，对头孢曲松为78%。分离出的微生物及其对抗生素的敏感性与年龄、性别、耳漏持续时间、肉芽组织或息肉的存在无关。我们认为，当考虑对非胆脂瘤型慢性化脓性中耳炎进行非手术治疗时，我们的数据可能有助于合理选择抗生素。
