Amoxicillin/clavulanate treatment in secretory otitis media. Bacteriological findings in the nasopharynx.

A double blind, placebo controlled study was undertaken to evaluate the antibiotic impact of amoxicillin/clavulanate acid on the nasopharyngeal flora in children treated for 4 weeks for secretory otitis media (SOM). In 131 children who received antibiotic, a significant fall in H. influenzae and S. pneumoniae was observed in comparison to 133 children who received placebo. Beta-haemolytic streptococci and S. aureus were less frequent and did not decrease significantly. One month after discontinuation of treatment the nasopharyngeal bacterial flora was restored to pretreatment level. Seasonal variation was found only for S. pneumoniae. No persistent beta-lactamase producing H. influenzae was noticed. In the light of previously published results this study confirms that the nasopharyngeal flora plays an aetiological role in the development of SOM in children, and that the used antibiotic did not disturb the nasopharyngeal flora in the long run.