U. Šivic
Klinika za infekcijske bolezni in vročinska stanja, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

J. Rebol
Oddelek za otorinolaringologijo, cervikalno in maksilofacialno kirurgijo, Univerzitetni klinični center Maribor, Maribor, Slovenija

Abstract

Background: The aim of the retrospective study was to establish the incidence of acute otitis media that required surgical treatment at University Medical Centre (UMC) Maribor, the pathogens found and the antibiotic prescribing pattern. Materials, subjects and methods: The demographic, clinical and microbiological data were obtained from the medical documentation of the children younger than eight years of age, who were hospitalised and treated surgically for an acute purulent otitis media or mastoiditis at UMC Maribor between 2004 and 2013. Results: The incidence of acute otitis media treated surgically in the Podravska region was 39.1/100 000 children/year. The most prevalent isolated pathogen was Streptococcus pneumoniae (46.9 % of episodes in which the pathogen was identified). All pneumococcal isolates had a minimum inhibitory concentration (MIC) of penicillin ≤ 2 mg/L. There was no resistance to fluoroquinolones and vancomycin. The sensitivity to macrolides, tetracycline, trimethoprim/sulfamethoxazole and clindamycin was 64.9 %, 68.4 %, 51.4 %, and 71.3 % respectively. In the outpatient setting, children most commonly received one of the cephalosporins (36.9 %), amoxicillin (29.2 %) and amox- icillin with clavulanic acid (29.2 %). The most commonly prescribed intravenous antibiotics were cefuroxime (53.9 %) and amoxicillin with clavulanic acid (27.7 %). Conclusions: There is regional variation in the incidence of surgically treated otitis media. The susceptibility of Streptococcus pneumoniae to penicillin is good, so empirical treatment of acute otitis media with amoxicillin in a dose of 40−50 mg/kg/ day is effective. Broad-spectrum antibiotics are overprescribed.

Key words: acute otitis media, acute mastoiditis, myringotomy, mastoidectomy, Streptococcus pneumoniae, penicillin.