{alpha}Streptococci and recurrences of otitis media

doi:10.1136/bmj.322.7301.1543

BMJ 2001;322:1543 ( 23 June )

Letters

$alpha$ Streptococci and recurrences of otitis media

Right choice of antibiotic can decrease risk of recurrence

Tampering with microbial ecology is risky

Authors' reply

Right choice of antibiotic can decrease risk of recurrence

The first 150 words of the full text of this article appear below.

EDITOR $---$ Roos et al showed that $alpha$ haemolytic streptococci $---$ a part of the normal flora $---$ have a protective effect against otitismedia.¹ Even though the effect was modest, this finding isremarkable and should influence antibioticpolicy.

Broad spectrum antibiotics impair the normal flora. In a recent epidemiological survey we found an association between theuse of such antibiotics and an increased risk of recurrence ofacute otitis media (broad spectrum antibiotics v phenoxymethylpenicillin:odds ratio 1.8 (95% confidence interval 1.3 to 2.6)).² Howardet al showed that recurrences were less common among childrentreated with a narrow spectrum drug (penicillin or erythromycin)than among those treated with a broad spectrum antimicrobial (amoxicillinor erythromycin plus sulphonamide) (13.3% v 40.5%, P=0.0125).³

Nowadays, broad spectrum antibiotics are increasingly used to treat otitis, although the clinical picture of this diseasehas become milder.² Broad spectrum drugs have not been shownto have therapeutic advantages . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Effect of recolonisation with "interfering" $alpha$ streptococci on recurrences of acute and secretory otitis media in children: randomised placebo controlled trial: Kristian Roos, Eva Grahn Håkansson, and Stig Holm
BMJ 2001 322: 210. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Is best choice of antibiotic "no antibiotic"?: John Goldsmith
bmj.com, 26 Jun 2001 [Full text]
Re: Is best choice of antibiotic "no antibiotic"?: Andrew Falloon
bmj.com, 27 Jun 2001 [Full text]