Michael W Mather1, Michael Drinnan2, John D Perry3, Steven Powell4, Janet A Wilson5, Jason Powell6. 1. Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK; Department of Otolaryngology, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK. 2. Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK. 3. Department of Microbiology, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK. 4. Department of Otolaryngology, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK. 5. Department of Otolaryngology, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK; Institute of Health and Society, Newcastle University, Richardson Road, Newcastle Upon Tyne, NE2 4AX, UK. 6. Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK; Department of Otolaryngology, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK. Electronic address: jason.powell@newcastle.ac.uk.
Abstract
OBJECTIVE OF REVIEW: Acute otitis media (AOM) is the largest cause of antimicrobial prescriptions amongst children in developed countries. Excessive and inappropriate prescribing is known to drive antimicrobial resistance, but less is known of antimicrobial resistance in AOM-associated bacteria. TYPE OF REVIEW & SEARCH STRATEGY: We conducted a systematic review and meta-analysis of bacterial prevalence and antimicrobial resistance in studies of paediatric AOM identified from Ovid Medline, Embase and the Cochrane library. RESULTS: From 48 unique studies, 15,871 samples were included. Only 0.67 (CI 0.63-0.71) of all ear samples grew a bacterial pathogen. The most common bacterial causes of AOM in children were Streptococcus pneumoniae 0.30 (CI 0.27-0.32), Haemophilus influenza 0.23 (CI 0.20-0.26), and Moraxella catarrhalis 0.05 (CI 0.04-0.06). Resistance patterns varied amongst organisms and antimicrobial agents. The pooled proportion of bacterial culture-positive episodes of AOM that could be effectively treated with amoxicillin was 0.85 (CI 0.76-0.94), erythromycin was 0.64 (0.48-0.78) and amoxicillin-clavulanate was 0.95 (CI 0.85-0.98). CONCLUSION: We have demonstrated the bacteriology and antimicrobial resistance patterns of AOM. Of samples which grew bacteria, on average approximately 15% of isolates demonstrated resistance to amoxicillin; a typical first-line agent. Greater understanding of local bacteriology and resistance patterns is needed to enable improved antimicrobial stewardship.
OBJECTIVE OF REVIEW: Acute otitis media (AOM) is the largest cause of antimicrobial prescriptions amongst children in developed countries. Excessive and inappropriate prescribing is known to drive antimicrobial resistance, but less is known of antimicrobial resistance in AOM-associated bacteria. TYPE OF REVIEW & SEARCH STRATEGY: We conducted a systematic review and meta-analysis of bacterial prevalence and antimicrobial resistance in studies of paediatric AOM identified from Ovid Medline, Embase and the Cochrane library. RESULTS: From 48 unique studies, 15,871 samples were included. Only 0.67 (CI 0.63-0.71) of all ear samples grew a bacterial pathogen. The most common bacterial causes of AOM in children were Streptococcus pneumoniae 0.30 (CI 0.27-0.32), Haemophilus influenza 0.23 (CI 0.20-0.26), and Moraxella catarrhalis 0.05 (CI 0.04-0.06). Resistance patterns varied amongst organisms and antimicrobial agents. The pooled proportion of bacterial culture-positive episodes of AOM that could be effectively treated with amoxicillin was 0.85 (CI 0.76-0.94), erythromycin was 0.64 (0.48-0.78) and amoxicillin-clavulanate was 0.95 (CI 0.85-0.98). CONCLUSION: We have demonstrated the bacteriology and antimicrobial resistance patterns of AOM. Of samples which grew bacteria, on average approximately 15% of isolates demonstrated resistance to amoxicillin; a typical first-line agent. Greater understanding of local bacteriology and resistance patterns is needed to enable improved antimicrobial stewardship.
Authors: Michael W Mather; Steven Powell; Benjamin Talks; Chris Ward; Colin D Bingle; Muzlifah Haniffa; Jason Powell Journal: Expert Rev Mol Med Date: 2021-08-18 Impact factor: 7.615
Authors: Emily R Smith; Alicia M Fry; Lauri A Hicks; Katherine E Fleming-Dutra; Brendan Flannery; Jill Ferdinands; Melissa A Rolfes; Emily T Martin; Arnold S Monto; Richard K Zimmerman; Mary Patricia Nowalk; Michael L Jackson; Huong Q McLean; Scott C Olson; Manjusha Gaglani; Manish M Patel Journal: Clin Infect Dis Date: 2020-12-31 Impact factor: 20.999
Authors: Michael William Mather; Bernard Verdon; Rachel Anne Botting; Justin Engelbert; Livia Delpiano; Xin Xu; Catherine Hatton; Tracey Davey; Steven Lisgo; Philip Yates; Nicholas Dawe; Colin D Bingle; Muzlifah Haniffa; Jason Powell; Chris Ward Journal: Laryngoscope Investig Otolaryngol Date: 2021-09-18
Authors: Saskia Hullegie; Roderick P Venekamp; Thijs M A van Dongen; Alastair D Hay; Michael V Moore; Paul Little; Anne G M Schilder; Roger A M J Damoiseaux Journal: Pediatr Infect Dis J Date: 2021-08-01 Impact factor: 2.129