Shurin P A, Van Hare G F
Drugs. 1986;31 Suppl 3:122-4. doi: 10.2165/00003495-198600313-00027.
Since 1980, we have observed an increased incidence of otitis media caused by Branhamella catarrhalis. The outcome of therapy of acute otitis media caused by this organism has been studied in a number of randomised clinical trials. 75% of isolates produced beta-lactamase. Failure to sterilise B. catarrhalis-infected middle ear exudates occurred in 3 of 11 patients treated with amoxycillin or bacampicillin, 2 of 19 treated with cefaclor, but in no patients treated with co-trimoxazole (n = 10) or amoxycillin-clavulanic acid (Augmentin), [n = 9]. All treatment failures were associated with beta-lactamase-producing strains of B. catarrhalis. The emergence of antibiotic-resistant strains of B. catarrhalis in acute otitis media indicates the need for a re-evaluation of initial antibiotic therapy of this infection. This may be particularly true for areas where there is a high incidence of strains which elaborate beta-lactamase.
自1980年以来，我们观察到由卡他布兰汉菌引起的中耳炎发病率有所上升。已经在多项随机临床试验中研究了由该病原体引起的急性中耳炎的治疗结果。75%的分离株产生β-内酰胺酶。在接受阿莫西林或巴坎西林治疗的11例患者中，有3例未能清除卡他布兰汉菌感染的中耳渗出物；在接受头孢克洛治疗的19例患者中，有2例出现这种情况；但在接受复方新诺明（n = 10）或阿莫西林-克拉维酸（安灭菌）治疗的患者中（n = 9）均未出现这种情况。所有治疗失败均与产生β-内酰胺酶的卡他布兰汉菌菌株有关。卡他布兰汉菌抗生素耐药菌株在急性中耳炎中的出现表明需要重新评估这种感染的初始抗生素治疗。对于那些产生β-内酰胺酶菌株发病率较高的地区，情况可能尤其如此。
