Otitis media complications and treatment failures: implications of pneumococcal resistance
Otitis media complications and treatment failures: implications of pneumococcal resistance
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中耳炎并发症和治疗失败：肺炎球菌耐药性的影响
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
M. D. Poole
中科院分区：
文献类型：
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作者：
M. D. Poole
未经治疗的中耳炎的典型并发症包括脑膜炎、侧窦血栓形成和慢性化脓性中耳炎。过去，在通常治疗中耳炎的国家，并发症很少见，因为几乎所有口服抗生素对最常见的并发症原因肺炎链球菌都有良好的活性。治疗失败通常是由产生β-内酰胺酶的非分型流感嗜血杆菌或卡他莫拉氏菌引起的，很少与严重的全身感染有关。然而，随着多重耐药肺炎球菌的出现，面对我们最有效的抗菌剂，可能会发生严重和致命的感染。出现耐多药肺炎球菌的后果可能包括更持久的化脓性中耳炎，广谱抗生素的使用增加，中耳炎的手术治疗率增加，并最终增加中耳炎的化脓性并发症。治疗失败可能已经超过咽鼓管功能障碍，成为鼓室造瘘管置入的最常见原因。多重耐药肺炎球菌有望改变目前初级和二级保健的管理方式。
Classic complications of untreated otitis media include meningitis, lateral sinus thrombosis and chronic suppurative otitis media. In the past, in countries where otitis media is usually treated, complications have been rare, because of the good activity of almost all orally administered antibiotics against the most common cause of complications, Streptococcus pneumoniae. Treatment failures were usually caused by betalactamase-producing nontypable Haemophilus influenzae or by Moraxella (Branhamella) catarrhalis and were rarely associated with serious systemic infections. With the advent of multidrug-resistant pneumococci, however, serious and fatal infections can occur in the face of our most potent antimicrobial agents. The consequences of the emergence of multidrug-resistant pneumococci are likely to include more persistent purulent otitis media, increased usage of broad-spectrum antibiotics, an increase in surgical treatment rates for otitis media and, eventually, an increase in suppurative complications of otitis media. Medical treatment failures probably already surpass eustachian tube dysfunction as the most common reason for tympanostomy tube insertion. Multidrug-resistant pneumococci may be expected to change the way in which primary and secondary care is currently administered.