Effects of Amoxicillin/Clavulanate or Azithromycin on Nasopharyngeal Carriage ofStreptococcus pneumoniaeandHaemophilus influenzaein Children with Acute Otitis Media | Zendy

Faryal Ghaffar | Zendy; Luz Stella Muniz | Zendy; Kathy Katz | Zendy; Jason Reynolds | Zendy; Jeanette L. Smith | Zendy; Phyllis Davis | Zendy; Ian R. Friedland | Zendy; George H. McCracken | Zendy

Open Access

Effects of Amoxicillin/Clavulanate or Azithromycin on Nasopharyngeal Carriage ofStreptococcus pneumoniaeandHaemophilus influenzaein Children with Acute Otitis Media

Author(s) -

Faryal Ghaffar,

Luz Stella Muniz,

Kathy Katz,

Jason Reynolds,

Jeanette L. Smith,

Phyllis Davis,

Ian R. Friedland,

George H. McCracken

Publication year - 2000

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/318160

Subject(s) - azithromycin , medicine , haemophilus influenzae , streptococcus pneumoniae , amoxicillin , penicillin , microbiology and biotechnology , carriage , clavulanic acid , antibiotics , population , otitis , virology , biology , surgery , environmental health , pathology

The effect of antibiotic therapy on nasopharyngeal colonization by Streptococcus pneumoniae and Haemophilus influenzae was evaluated in children diagnosed with acute otitis media. Children were randomly assigned to receive either amoxicillin/clavulanate or azithromycin therapy, and nasopharyngeal swabs were obtained for culture before and after starting therapy. Amoxicillin/clavulanate therapy eradicated or suppressed all strains of S. pneumoniae susceptible to penicillin, 75% of strains with intermediate resistance, and 40% of strains resistant to penicillin. Azithromycin therapy cleared two-thirds of azithromycin-susceptible strains of S. pneumoniae but none of azithromycin-nonsusceptible strains. Selection for antibiotic-resistant strains in individual children was not observed in children who received amoxicillin/clavulanate therapy but was observed in 2 children who received azithromycin therapy. Carriage of H. influenzae was also reduced by antimicrobial therapy but more so by amoxicillin/clavulanate. Antibiotic therapy does not directly increase the number of resistant strains in the population but, by eradicating susceptible strains, allows greater opportunity for carriage and spread of resistant strains.

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