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Volume 10

Journal of Archives of Medicine

Advanced Biotechnology & Annual Pediatrics 2018

November 28-29, 2018

Novel Trends and Advances in Biotechnology,

Cell & Stem Cell Research

Annual Congress on Pediatrics

World Congress on

November 28-29, 2018 Barcelona, Spain

Joint Event On

Errors in antibiotic therapy of acute otitis media in children

Raushan N Mamleev

Kursk State Medical University, Russian Federation.

Statement of the Problem:

Acute Otitis Media (AOM) is one of the most common diseases in children. AOM is 25-40% in

the structure of all pediatric ENT-pathology in Russia. Approximately 42% of prescriptions for oral antibiotics in children are

prescribed for AOM. Mastoiditis is the most frequent and dramatic complication of AOM.

Methodology &Theoretical Orientation:

We have analyzed the history of children with acute mastoiditis. For the period from

2009 to 2017 in our clinic made 161 antromastoidotomy. In the diagram obvious the increase in surgical activity, indicating

an increase in the frequency of complicated AOM. In 46 cases, mastoiditis was accompanied by subperiosteal abscesses, 4 -

perisinuous abscesses, 4 – thrombosis of the sigmoid sinus, 2 - abscess of the cerebellum, 1 - epidural abscess of the temporal

lobe. Otogenic meningitis was diagnosed in 7 patients. None of the children were vaccinated against pneumococcal infection.

Findings:

The high frequency of complications of acute otitis media in children is due to errors in antibiotic therapy. Analysis

of failures of starting treatment revealed three main reasons: (1) The use of low doses (20-30 mg/kg/day) of amoxicillin, creating

suboptimal concentrations of the antibiotic in the focus of inflammation; (2) the empirical appointment of oral cephalosporins of

the 3rd generation (cefixime and, especially, ceftibutene), which have a reduced antipneumococcal activity; (3) use of macrolides

as a first-line therapy (due to the progressive decrease of susceptibility of pneumococci to 14- and 15-member macrolides).

Conclusion & Significance:

Despite vaccination against pneumococcus since 2014, Streptococcus pneumonia remains the

main causative agent of AOM in Russia; this is due to the anti-vaccination approach among the population. At this stage, the

treatment of AOM requires high anti-pneumococcal activity of starting antibiotics (amoxicillin in doses of 60-90 mg/kg/day

or ceftriaxone in a dose of 75 mg/kg/day).

Arch Med 2018, Volume 10

DOI: 10.21767/1989-5216-C2-006