The effects of co-amoxiclav (AMC) and amoxicillin (AMX) therapy on the nasopharyngeal flora of children with acute otitis media (AOM) were compared. Nasopharyngeal culture for aerobic and anaerobic bacteria were obtained before therapy and 2–4 days after completion of antimicrobial therapy in 25 patients treated with either antibiotic. After therapy, 16 (64%) of the 25 patients treated with AMX and 23 (92%) of the 25 patients treated with AMC were considered clinically cured. Polymicrobial aerobic–anaerobic flora were present in all instances. A significant reduction in the number of both aerobic and anaerobic isolates occurred after therapy in those treated with AMX (177 isolates versus 133, P< 0.005) and AMC (172 isolates versus 60, P< 0.001). However, the number of all isolates recovered after therapy in those treated with AMC was significantly lower (60 isolates) than in those treated with AMX (133 isolates, P < 0.001). The recovery of known aerobic pathogens (e.g. Streptococcus pneumoniae, Staphylococcus aureus, β-haemolytic streptococci, Haemophilus species and Moraxella catarrhalis) and penicillin-resistant bacteria after therapy was lower in the AMC group than in the AMX group (P < 0.005). This study illustrates the greater ability of AMC, compared with AMX, to reduce the number of potential nasopharyngeal pathogens and penicillin-resistant bacteria in children with AOM.
比较共阿莫西拉(
AMC)和
阿莫西林(AMX)治疗对急性中耳炎(AOM)患儿鼻咽部菌群的影响。对 25 名接受任一抗生素治疗的患者在治疗前和完成抗菌治疗后 2-4 天进行鼻咽需氧菌和厌氧菌培养。治疗后,接受 AMX 治疗的 25 名患者中的 16 名 (64%) 和接受
AMC 治疗的 25 名患者中的 23 名 (92%) 被认为临床治愈。所有实例中均存在多种需氧-厌氧微
生物菌群。使用 AMX(177 株对 133 株,P < 0.005)和 AMC(172 株对 60 株,P < 0.001)治疗后,需氧菌和厌氧菌的数量均显着减少。然而,接受 AMC 治疗的患者治疗后恢复的所有分离株数量(60 个分离株)显着低于接受 AMX 治疗的患者(133 个分离株,P < 0.001)。 AMC组治疗后已知需氧病原体(例如肺炎链球菌、金黄色葡萄球菌、β-溶血性链球菌、嗜血杆菌和卡他莫拉菌)和青霉素耐药菌的恢复率低于AMX组(P < 0.005)。这项研究表明,与 AMX 相比,AMC 在减少 AOM 儿童潜在鼻咽病原体和
青霉素耐药细菌数量方面具有更大的能力。