Management of acute otitis media caused by resistant pneumococci in infants

OBJECTIVES.To assess the clinical outcome and risk of failure after oral vs. intravenous treatment in otitis media caused by penicillin-resistant pneumococci. To determine the possible correlations between pneumococcal minimal inhibitory concentration (MIC) to penicillin and clinical outcome. DESIGN.Retrospective study of 156 cases collected between 1993 and 1995. Mean follow-up5 months. SETTING.Two tertiary academic medical centers in Paris, France. PATIENTS AND METHODS.Pneumococcus was isolated from 191 of 570 ear samples obtained from children with otitis media and shown to be penicillin-resistant in 156. Medical history, antibiotic therapy during the previous 3 months and day-care center attendance were reviewed. For the current episode microbiologic characteristics of the isolated strains, type of treatment, therapy efficacy and clinical outcome were analyzed.Patients were predominantly young (76.3% were