2歳未満の急性中耳炎の病態とトスフロキサシンの有効性

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Children under the age of 2 years are in a functionally and immunologically immature state and are likely to have a refractory course when diagnosed with acute otitis media (AOM). To clarify the clinical characteristics of AOM in children under 2 years of age (AOM<2), the clinical backgrounds and bacterial pathogens were compared between AOM<2 and AOM in children aged 2 years or older (AOM≧2). Furthermore, the clinical efficacy of treatment with tosufloxacin (tosufloxacin tosilate hydrate, TFLX) on acute otitis media was evaluated in these two age groups. The AOM<2 group had a higher incidence of recurrent and prolonged infections over 3 weeks compared with the AOM≧2 group. In the AOM<2 group, Haemophilus influenzae and Streptococcus pneumoniae, the 2 major pathogenic bacteria, were responsible for 66.7% and 25.6% of the cases, respectively, while in the AOM≧2 group, Haemophilus influenzae and Streptococcus pneumoniae were responsible for 41.1% and 70.5% of the cases, respectively. More than 90% of the isolates were antimicrobial-resistant strains, i.e., β-lactamase non-producing ampicillin resistant Haemophilus influenzae (BLNAR) or penicillin-resistant Streptococcus pneumoniae (PRSP). The present study showed that TFLX was highly effective for the treatment of acute otitis media in both age groups. Based on these results, AOM in patients who are under 2 years of age is likely to be more refractory and to be frequently caused by BLNAR and PRSP. We confirmed that TFLX is effective in patients with a recurrent and prolonged course and should be the drug of choice for children with pretreated and refractory AOM.

2歳未満の急性中耳炎の病態とトスフロキサシンの有効性

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