EFFECT OF PRIOR ANTIBIOTIC-TREATMENT ON MIDDLE-EAR DISEASE IN CHILDREN

The effect of prior antibiotic treatment on the course of otitis media was assessed in a group of 62 children who experienced 83 episodes of ear infection during 3 years of observation. Bacterial quantitation in middle ear fluids demonstrated a significantly higher colony count in symptomatic children (3.9 x 10(4) +/- 12 bacteria per milliliter) compared to asymptomatic children (6.3 x 10(3) +/- 10 bacteria per milliliter; p = .05). Bacterial counts similarly tended to be higher in children with Streptococcus pneumoniae (4.0 x 10(6) +/- 16 bacteria per milliliter) and Hemophilus influenzae (2.0 x 10(6) +/- 16 bacteria per milliliter), who were more often symptomatic (73 % and 55%, respectively, versus 38 %) than children with Moraxella catarrhalis (7.9 x 10(3) +/- 2). Antibiotic therapy between 3 and 30 days prior to bacterial diagnosis was associated with a reduction in symptoms from 70 % to 38 % (p < .025). However, prior treatment did not statistically reduce bacterial colony counts, although S pneumoniae decreased 90 % in the previously treated group. Resistance to ampicillin occurred in 0% of S pneumoniae, 39 % of nontypable H influenzae, and 80 % of M catarrhalis subjects without prior treatment and in 0 %, 46%, and 100 %, respectively, of subjects previously treated (p < .025). These data suggest that prior treatment has a significant impact on the subsequent course of otitis media in children.