Following positive intraoperative cultures for
M catarrhalis, 2 g IV of cefepime was administered per infectious disease recommendations.
NP swabs were taken at 6 weeks and 6, 12, 18, and 24 months and were cultured for Spneumoniae, H influenzae, M catarrhalis, and S aureus.
M catarrhalis carriage rates increased from approximately 25% at 6 weeks to approximately 65% at 6 months; there were no significant differences among groups.
That dose, as we now know from double-tap eradication studies, is likely to fail to eradicate 25 to 40% of even the beta-lactamase-negative strains, and it appears to be no better than placebo against beta-lactamase-producing strains of H influenzae and
M catarrhalis. (5,6)
This 2-year prospective study evaluated NP carriage and antibiotic resistance of S pneumoniae, S aureus, H influenzae, M catarrhalis, and Streptococcus pyogenes in 346 children attending kindergarten in Brussels, Belgium, from October 2006 to May 2008.
Global carriage rates were 43.3 % for S pneumoniae, 31.4% for S aureus, 60.1% for H influenzae, 41.3% for M catarrhalis, and 2.9% for S pyogenes.
Goldblatt et al showed that topical ofloxacin was more effective than oral amoxicillin/clavulanate when S aureus or P aeruginosa was present (although the two were equal when S pneumoniae,
M catarrhalis, or H influenzae was present).
Cocolonization with both S pneumoniae and
M catarrhalis was most common among children with URTIs; cocolonization with both S pneumoniae and H influenzae was most common among children with URTIs or with adenoid vegetations/chronic rhinitis.
Sulfacetamide drops are bacteriostatic against H influenzae,
M catarrhalis, and most pneumococci, which are common organisms seen in acute otitis media and chronic otitis media with effusion.