Julien N, Perié S, Lassen C, Sevali Garcia J, Sterkers O
Service d'ORL, Hôpital Beaujon, Clichy.
Ann Otolaryngol Chir Cervicofac. 1993;110(2):81-6.
Antimicrobial sampling was performed in the external auditory canal and in the mastoid cavity when possible in 80 middle ears operated on during the last 15 months. These samplings concerned 20 cholesteatomas. 25 suppurative chronic otitis, 25 non suppurative chronic otitis and 6 miscellaneous. In 20 out of 80 cases (25%), one or several microbial agents were identified: cholesteatomas (35%), suppurative chronic otitis (38%), non suppurative ones (4%) and miscellaneous (16%). In most cases a staphylococcus or a negative gram agent was sensitive to amoxycillin-clavulanique acid. When sampling was performed in the mastoid cavity, the agent was not sensitive to this antibiotic (80% of cases). This study demonstrates that a prophylactic therapy against aerobic and anaerobic agents is necessary in non suppurative chronic otitis whereas the antimicrobial therapy must be adapted in other pathologies.
在过去15个月内接受手术的80例中耳病例中,尽可能对外耳道和乳突腔进行了抗菌采样。这些采样涉及20例胆脂瘤、25例化脓性慢性中耳炎、25例非化脓性慢性中耳炎和6例其他杂症。80例病例中有20例(25%)鉴定出一种或几种微生物病原体:胆脂瘤(35%)、化脓性慢性中耳炎(38%)、非化脓性慢性中耳炎(4%)和其他杂症(16%)。在大多数情况下,葡萄球菌或革兰氏阴性菌对阿莫西林-克拉维酸敏感。当在乳突腔进行采样时,病原体对这种抗生素不敏感(80%的病例)。本研究表明,非化脓性慢性中耳炎需要针对需氧菌和厌氧菌进行预防性治疗,而其他病理情况的抗菌治疗必须进行调整。