A single intramuscular dose of ceftriaxone changes nasopharyngeal bacterial flora in children with acute otitis media.
A single intramuscular dose of ceftriaxone changes nasopharyngeal bacterial flora in children with acute otitis media.
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单次肌肉注射头孢曲松会改变急性中耳炎儿童的鼻咽细菌菌群。
DOI：
10.1080/080352500300002499
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Chonmaitree,T
中科院分区：
文献类型：
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作者：
Heikkinen,T;Saeed,KA;McCormick,DP;Baldwin,C;Reisner,BS;Chonmaitree,T
抗生素的广泛使用导致鼻咽部细菌植物群的选择性压力，从而导致耐药菌的患病率增加。已经提出缩短抗生素疗程以减少耐药菌株的发展。我们测定了167名急性中耳炎儿童（中位年龄13个月）单次肌肉注射头孢曲松（50 mg/kg）对鼻咽部细菌植物群的影响。在头孢曲松治疗前和治疗后5 d采集鼻咽部标本进行细菌培养。治疗前，99例（59%）儿童分离出卡他莫拉菌，87例（52%）分离出肺炎链球菌，53例（32%）分离出流感嗜血杆菌。治疗后，M. 62例（37%）儿童出现卡他炎，使卡他炎的定植率下降37%（p< 0.001）。50例（30%;下降43%）分离肺炎;治疗后17例（10%;减少68%）儿童发生流感（两者均P< 0.001）。治疗前，60%的肺炎球菌分离株对青霉素敏感，26%为中度敏感，14%为青霉素耐药。根除S.肺炎主要发生在携带青霉素敏感菌株的儿童中。因此，治疗后残留的肺炎球菌菌株中，只有24%对青霉素敏感，59%为青霉素中间型，16%为青霉素耐药。单剂量头孢曲松导致鼻咽部细菌植物群发生显著变化，增加了对青霉素敏感性降低的肺炎球菌菌株的相对患病率。
The increasing prevalence of drug‐resistant bacteria is attributed to the extensive use of antibiotics, which causes selective pressure on the nasopharyngeal bacterial flora. Shortened courses of antibiotics have been proposed to decrease the development of resistant strains. We determined the effect of a single intramuscular dose of ceftriaxone (50 mg/kg) on the nasopharyngeal bacterial flora in 167 children (median age 13 mo) with acute otitis media. Nasopharyngeal samples for bacterial culture were obtained before and 5 d after treatment with ceftriaxone. Before treatment,Moraxella catarrhaliswas isolated in 99 (59%) children,Streptococcus pneumoniaein 87 (52%), andHaemophilus influenzaein 53 (32%). After treatment,M. catarrhaliswas found in 62 (37%) children, which constitutes a 37% decrease in the colonization rate by this pathogen (p< 0.001).S. pneumoniaewas isolated in 50 (30%; 43% decrease) andH. influenzaein 17 (10%; 68% decrease) children after treatment (p< 0.001 for both). Before treatment, 60% of pneumococcal isolates were sensitive to penicillin, 26% were of intermediate susceptibility, and 14% were penicillin‐resistant. Eradication ofS. pneumoniaeoccurred mainly in children with penicillin‐sensitive isolates. As a consequence, only 24% of pneumococcal isolates that remained after treatment were sensitive to penicillin, 59% were penicillin‐intermediate, and 16% were penicillin‐resistant.A single dose of ceftriaxone resulted in significant changes in the nasopharyngeal bacterial flora, increasing the relative prevalence of pneumococcal strains with decreased susceptibility to penicillin.