Bluestone C D
Otitis Media Research Center, Children's Hospital of Pittsburgh, PA 15213-3417.
Pediatr Infect Dis J. 1988 Nov;7(11 Suppl):S129-36. doi: 10.1097/00006454-198811001-00002.
Otitis media, the diagnosis most frequently made by the pediatrician, is most effectively treated with antimicrobial therapy. Amoxicillin (or ampicillin) has been the standard for infants and children with acute otitis media because it is safe and effective for most of the causative bacterial pathogens. Amoxicillin has also been shown to be effective for treatment of some children with otitis media with effusion ("secretory" otitis media) and is the recommended prophylactic antimicrobial agent for prevention of frequently recurrent acute otitis media. However, during the past decade there has been an increasing rate of bacteria that are resistant to amoxicillin, primarily beta-lactamase-producing Haemophilus influenzae and Branhamella catarrhalis. Because of the emergence of these bacteria, other antimicrobial agents both old and new have been advocated for treatment and prevention of otitis media; amoxicillin-clavulanate and cefuroxime axetil are the newer agents. These agents are indicated for selected infants and children but for most patients amoxicillin remains a safe and relatively inexpensive effective "old friend".
中耳炎是儿科医生最常做出的诊断，抗菌治疗对其疗效最为显著。阿莫西林（或氨苄西林）一直是治疗婴幼儿急性中耳炎的标准用药，因为它对大多数致病细菌病原体安全有效。阿莫西林还被证明对一些分泌性中耳炎患儿有效，并且是预防频繁复发的急性中耳炎的推荐预防性抗菌药物。然而，在过去十年中，对阿莫西林耐药的细菌比例不断上升，主要是产β-内酰胺酶的流感嗜血杆菌和卡他莫拉菌。由于这些细菌的出现，新老抗菌药物都被推荐用于治疗和预防中耳炎；阿莫西林-克拉维酸盐和头孢呋辛酯是较新的药物。这些药物适用于特定的婴幼儿，但对大多数患者来说，阿莫西林仍然是一种安全、相对便宜且有效的“老朋友”。
