Journal of the Korean Pediatric Society 2003;46(5):459-466.
Published online May 15, 2003.
Causative Pathogens and Therapeutic Assessment of Cefprozil in Acute Otitis Media
Jin-Han Kang1, Jong Hyun Kim1, Yong-Soo Park2, Young-Chul Choi2, Heil Noh2, Hoon Shik Yang3, Kyu Sung Kim4, Yeon Sook Moon5, Young Jin Hong6
1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
2Department of Otolaryngology, College of Medicine, The Catholic University of Korea, Korea
3Department of Otolaryngology, College of Medicine, Chung-Ang University, Seoul, Korea
4Department of Otolaryngology, College of Medicine, Inha University, Incheon, Korea
5Department of Clinical Pathology, College of Medicine, Inha University, Incheon, Korea
6Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
급성 중이염의 원인 병원균과 Cefprozil 치료의 임상적 평가
강진한1, 김종현1, 박용수2, 최영철2, 노해일2, 양훈식3, 김규성4, 문연숙5, 홍영진6
1가톨릭대학교 의과대학 소아과학교실
2가톨릭대학교 의과대학 이비인후과학교실
3중앙대학교 의과대학 이비인후과학교실
4인하대학교 의과대학 이비인후과교실
5인하대학교 의과대학 임상병리학교실
6인하대학교 의과대학 소아과학교실
Correspondence: 
Jin-Han Kang, Email: kjhan@olmh.cuk.ac.kr
Abstract
Purpose
: AOM is the most common bacterial URI in children. The bacteriology and antibiotic Tx of AOM in children has been studied in many countries. But, there is few study of causative pathogens and antibiotic Tx of AOM in our country. In this aspect, we performed prospective clinical study to confirm the causative pathogens and assess the clinical responses of cefprozil in AOM patients.
Methods
: Thirty three AOM patients enrolled in this study. Tympanocentesis for isolation of causative pathogens were performed before Tx of cefprozil. The study patients received cefprozil with dose of 15 mg/kg/bid.po/day for 10-12 days, and initially assessed the clinical response at 4-5 days after receiving cefprozil and finally at the end visit. In vitro susceptibility tests of cefprozil to isolated pathogens were done by disc diffusion method, and in vitro susceptibility tests of cefaclor and cefixime to isolated pathogens were simultaneously performed.
Results
: Bacterial pathogens[S. pneumoniae(10), H. influenzae(5), S. aureus(2), M. catarrhalis(1) and Group A stretococcus(1)] were isolated from 19 patients. Clinically, all patients had history of abrupt high fever except one. Tympanic perforation was dominant in pathogens isolated cases, and otalgia was significantly developed in non-pathogens isolated cases. The ages of pathogens isolated cases were usually below 2 years. Eighty four point nine percent of the patients including two cases with isolation of intermediate resistant S. pneumoniae were clinically improved. Antimicrobial in vitro activity to S. pneumoniae of cefprozil were superior than that of cefacor and cefixime.
Conclusion
: We confirm that bacteria has the causative role in about 60% cases, and S. pneumoniae is the most common pathogen. Clinically, there were some differences in symptoms, signs and ages between pathogens isolated and non-pathogens isolated cases. The clinical responses of cefprozil in our patients revealed similar outcomes to other countries. And we reconfirm that cefprozil may be clinically effective in cases of AOM due to intermediate resistant S. pneumoniae.
Key Words: Acute otitis media(AOM), Causative pathogens, Cefprozil


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