PURPOSE: AOM is the most common bacterial URI in children. The bacteriology and antibiotic Tx of AOM in children has been studied in many countries. But, there is few study of causative pathogens and antibiotic Tx of AOM in our country. In this aspect, we performed prospective clinical study to confirm the causative pathogens and assess the clinical responses of cefprozil in AOM patients. METHODS: Thirty three AOM patients enrolled in this study. Tympanocentesis for isolation of causa tive pathogens were performed before Tx of cefprozil. The study patients received cefprozil with dose of 15 mg/kg/bid.po/day for 10-12 days, and initially assessed the clinical response at 4-5 days after receiving cefprozil and finally at the end visit. In vitro susceptibility tests of cefprozil to isolated pathogens were done by disc diffusion method, and in vitro susceptibility tests of cefaclor and cefixime to isolated pathogens were simultaneously performed. RESULTS: Bacterial pathogens[S. pneumoniae(10), H. influenzae(5), S. aureus(2), M. catarrhalis(1) and Group A stretococcus(1)] were isolated from 19 patients. Clinically, all patients had history of abrupt high fever except one. Tympanic perforation was dominant in pathogens isolated cases, and otalgia was significantly developed in non-pathogens isolated cases. The ages of pathogens isolated cases were usually below 2 years. Eighty four point nine percent of the patients including two cases with isolation of intermediate resistant S. pneumoniae were clinically improved. Antimicrobial in vitro activity to S. pneumoniae of cefprozil were superior than that of cefacor and cefixime. CONCLUSION: We confirm that bacteria has the causative role in about 60% cases, and S. pneumoniae is the most common pathogen. Clinically, there were some differences in symptoms, signs and ages between pathogens isolated and non-pathogens isolated cases. The clinical responses of cefprozil in our patients revealed similar outcomes to other countries. And we reconfirm that cefprozil may be clinically effective in cases of AOM due to intermediate resistant S. pneumoniae.
Bacteria ; Bacteriology ; Cefaclor ; Cefixime ; Child ; Diffusion ; Earache ; Fever ; Humans ; Otitis Media* ; Otitis* ; Pneumonia ; Prospective Studies

Antibacterial activity of EA, a preparation of water soluble components made from carpophores of Elfvingia applanata (Pers.) Karst, was examined by macrobroth diltution method against a number of bacterial species. Antibacterial effects of EA were expressed as minimal inhibitory concentration (MIC) for growth. Among twelve species of bacteria tested, six strains of each gram positive bacteria and gram negative bacteria, EA showed the most potent antibacterial activity against Staphylococcus epidermidis and Proteus vulgaris, of which MICs were 1.25 mg/ml of EA. To investigate the antibacterial effects of combinations of EA with third generation cepholosporins, such as cefotaxime, ceftriaxone, ceftazidime, and cefixime, the fractional inhibitory concentration (FIC) and fractional inhibitory concentration index (FICI) were determined by macrodilution checkerboard assay for twelve bacterial strains. Combinations of EA and third generation cephalosporins exhibited either additive or indifferent effects in most instances. However, synergistic effects were observed in six instances. No antagonistic effect was observed in any cases.
Bacteria ; Cefixime ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Cephalosporins* ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Proteus vulgaris ; Staphylococcus epidermidis

The aim of this study was to determine the minimal inhibitory concentration(MIC) of cefi- xime, which is a 3rd generation of cefalosporin, against 6 species of putative periodon- topathogens; Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Prevotella inter- media, Prevotella nigrescens, Tannerella forsythia and Porphyromonas gingivalis. The efficacy of cefixime was examined by comparing it with that of several antibiotics(amoxicillin, Aug- mentin(R) ciprofloxacin, metronidazole, and tetracycline), which were used as the control. The MIC was measured using a microdilution method. The MIC of cefixime against the putative periodotopathogens, as a single use regimen, was relatively lower than that of the other antibiotics. The MIC of cefixime/metronidazole against P. intermedia ChDC KB14, P. nigres- cens ChDC KB50, F. nucleatum ChDC PV-F37, F. nucleatum ChDC F130, and F. nucleatum ChDC F175, as a simultaneous regimen, was lower than that of the other antibiotics. The concentration of cefixime in the crevicular fluid of volunteers who received 250mg every 12 hours for 3 days was 9microgram/ml after 9 hours. In conclusion, cefixime showed good anti- microbial activity in a single treatment or as a combined therapy with amoxicillin, Aug- mentin(R) or metronidazole against 6 periodontopathogens.
Aggregatibacter actinomycetemcomitans ; Amoxicillin ; Anti-Bacterial Agents ; Cefixime* ; Ciprofloxacin ; Forsythia ; Fusobacterium nucleatum ; Metronidazole ; Porphyromonas gingivalis ; Prevotella ; Prevotella nigrescens ; Volunteers

BACKGROUND: The objective of this study was to obtain data on the susceptibility of oral antibiotics to pathogens responsible for acute uncomplicated cystitis in female outpatients. MATERIALS AND METHODS: We performed urine culture from total of 118 female outpatients with acute uncomplicated cystitis between October 2004 and June 2005. A total of 134 isolates were obtained from female outpatients with acute uncomplicated cystitis. Antimicrobial susceptibilities to ampicillin, amoxicillin, ciprofloxacin, levofloxacin, trimethoprim/sulfamethoxazole (TMP/SMX), and cefixime were determined by Densichek kit (Biomerieux Inc., USA) antimicrobial susceptibility test systems. RESULTS: The most prevalent causative organism was Escherichia coli (76.1%), followed by P. aeruginosa, S. agalactiae, E. faecium, S. aureus, K. pneumoniae, E. fecalis, E. aerogenes, K. oxytica. The mean rates of susceptibility to each drug were ampicillin 39.25%, amoxicillin 39.2%, ciprofloxacin 69.6%, levofloxacin 72.5%, TMP/SMX 39.2%, and cefixime 87.3%. CONCLUSION: Escherichia coli was the most important pathogen of acute uncomplicated cystitis in female outpatients. The high prevalence of resistance to ampicillin, amoxicillin and TMP/SMX suggests that they would not provide adequate initial therapy and therapies other than TMP/SMX may need to be considered. The prevalence of resistance to ciprofloxacin was higher than that of previous study. We think that the further evaluation for the pathogen of cystitis and the resistance of antibiotics is necessary.
Amoxicillin ; Ampicillin ; Anti-Bacterial Agents* ; Cefixime ; Ciprofloxacin ; Cystitis* ; Escherichia coli* ; Escherichia* ; Female* ; Humans ; Levofloxacin ; Outpatients* ; Pneumonia ; Prevalence

BACKGROUND: The objective of this study was to obtain data on the susceptibility of oral antibiotics to pathogens responsible for acute uncomplicated cystitis in female outpatients. MATERIALS AND METHODS: We performed urine culture from total of 118 female outpatients with acute uncomplicated cystitis between October 2004 and June 2005. A total of 134 isolates were obtained from female outpatients with acute uncomplicated cystitis. Antimicrobial susceptibilities to ampicillin, amoxicillin, ciprofloxacin, levofloxacin, trimethoprim/sulfamethoxazole (TMP/SMX), and cefixime were determined by Densichek kit (Biomerieux Inc., USA) antimicrobial susceptibility test systems. RESULTS: The most prevalent causative organism was Escherichia coli (76.1%), followed by P. aeruginosa, S. agalactiae, E. faecium, S. aureus, K. pneumoniae, E. fecalis, E. aerogenes, K. oxytica. The mean rates of susceptibility to each drug were ampicillin 39.25%, amoxicillin 39.2%, ciprofloxacin 69.6%, levofloxacin 72.5%, TMP/SMX 39.2%, and cefixime 87.3%. CONCLUSION: Escherichia coli was the most important pathogen of acute uncomplicated cystitis in female outpatients. The high prevalence of resistance to ampicillin, amoxicillin and TMP/SMX suggests that they would not provide adequate initial therapy and therapies other than TMP/SMX may need to be considered. The prevalence of resistance to ciprofloxacin was higher than that of previous study. We think that the further evaluation for the pathogen of cystitis and the resistance of antibiotics is necessary.
Amoxicillin ; Ampicillin ; Anti-Bacterial Agents* ; Cefixime ; Ciprofloxacin ; Cystitis* ; Escherichia coli* ; Escherichia* ; Female* ; Humans ; Levofloxacin ; Outpatients* ; Pneumonia ; Prevalence

PURPOSE: Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. METHODS: E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. RESULTS: Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. CONCLUSION: Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.
Anti-Bacterial Agents* ; beta-Lactamases ; Cefaclor ; Cefixime* ; Child ; Escherichia coli* ; Escherichia* ; Humans ; Korea ; Microbial Sensitivity Tests ; Outpatients ; Proteus ; Treatment Failure ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: The aim of this study was to determine the in vitro activity of cefditoren, an oral third-generation aminothiazolyl cephalosporin, against Streptococcus pneumoniae and Haemophilus influenzae clinical isolates in a tertiary hospital. METHODS: We have studied the in vitro activities of cefditoren and other oral antibiotics against 120 S. pneumoniae isolates, including 80 penicillin non-susceptible isolates and 80 H. influenzae isolates from clinical specimens of patients at the Asan Medical Center. Minimal inhibitory concentrations (MICs) were determined by the agar dilution method. RESULTS: All S. pneumoniae strains tested were inhibited by 1 g/mL of cefditoren (MIC50/MIC90 0.25/1 microgram/mL; range 0.015~1 microgram/mL). The MICs were lower for penicillin-susceptible S. pneumoniae (MIC90 0.015 g/mL) as compared to penicillin-intermediate resistant (MIC90 0.5 g/mL) or penicillin- resistant strains (MIC90 1 microgram/mL). Cefditoren was active against all tested H. influenzae strains (MIC50/MIC90 0.015/0.03 microgram/mL; range <0.008~0.03 g/mL) and its activity was comparable to levofloxacin and cefixime. CONCLUSIONS: Cefditoren had an excellent activity against S. pneumoniae and H. influenzae irrespective of penicillin or ampicillin resistance, respectively. The results of this study suggest that cefditoren is a good choice of an antibiotic to use for empirical oral treatment of community-acquired respiratory tract infections.
Agar ; Ampicillin Resistance ; Anti-Bacterial Agents ; Cefixime ; Chungcheongnam-do ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Influenza, Human ; Levofloxacin ; Penicillins ; Pneumonia ; Respiratory Tract Infections ; Streptococcus pneumoniae* ; Streptococcus* ; Tertiary Care Centers

PURPOSE: As the incidence of non-typhoidal salmonella strains resistant to antibiotics has been increased, we attempted to investigate clinical aspects of non-typhoidal salmonella gastroenteritis and antibiotics resistance. METHODS: From January 2000 to June 2002, 99 children with positive stool culture of non-typhoidal salmonella were studied about clinical features, the incidence of antibiotics and multi-drug resistance and the difference of incidence of antibiotics resistance according to immune status. RESULTS: There were 66 males and 33 females. The majority of them were under 5 years of age (71%). 25 children were immunocompromised due to chemotherapy, steroid or immunosuppressive treatment. Serogroup D was the most common isolates (65%) followed by B (16%), C (8%) and E (8%). Resistance rate of 30% to ampicillin, 12% to chloramphenicol, 20% to trimethoprim- sulfamethoxazole (TMP-SMX), 11% to cefotaxime and 8% to cefixime were obtained. All isolates were susceptible to ciprofloxacine. Resistance rate to cefotaxime and cefixime in immunocompromised patients was 24% and 14.3% respectively, which were significantly higher compared to that in immunocompetent patients (6.8%, 5.6%, p<0.05). 11 isolates were resistant to three or more antibiotics. The incidence of multi-drug resistant isolates was significantly higher in immunocompromised patients (24%) than that of immunocompetent patients (6.8%). CONCLUSION: Because of the high prevalence of non-typhoidal salmonella strains resistant to ampicillin, chloramphenicol and TMP-SMX, third-generation cephalosporin might be the treatment of choice in non-typhoidal salmonella gastroenteritis. In particular, antibiotics should be carefully selected in immunocompromised patients because non-typhoidal salmonellas from them showed the higher incidence of antibiotic resistance and multi-drug resistance.
Ampicillin ; Anti-Bacterial Agents* ; Cefixime ; Cefotaxime ; Child ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Drug Therapy ; Female ; Gastroenteritis* ; Humans ; Immunocompromised Host ; Incidence ; Male ; Prevalence ; Salmonella* ; Sulfamethoxazole ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: Nasopharyngeal bacterial flora can cause respiratory tract diseases as well as invasive bacterial diseases. Moraxella catarrhalis colonizing in the nasopharynx is considered an important potential pathogen with an increasing production of beta-lactamase. This study examined the nasopharyngeal colonization rate of M. catarrhalis and the antibiotic susceptibility of M. catarrhalis. MATERIALS AND METHODS: Healthy children who visited one of the three University hospitals in the Republic of Korea or attended a day-care center around the participating hospitals were enrolled in this study. The nasopharyngeal samples were obtained by nasopharyngeal washing with normal saline and M. catarrhalis was isolated. The nasopharyngeal colonization rate of M. catarrhalis was investigated and the minimal inhibitory concentrations (MICs) were measured for commonly used oral antibiotics (amoxicillin, amoxicillin/clavulanate, cefaclor, cefixime, cefdinir, cefditoren, erythromycin and trimethoprim). RESULTS: Three hundred and seventy-nine children aged between 6 months and 5 years were enrolled, and the nasopharyngeal colonization rate of M. catarrhalis was 33% (124 children). All isolated M. catarrhalis produced beta-lactamase. The MIC90 of the antibiotics were as follows: amoxicillin, >16 mg/L; amoxicillin/clavulanate, 0.5 mg/L; cefaclor, 8 mg/L ; cefixime, 0.125 mg/L; cefdinir, 0.25 mg/L; cefditoren, 0.25 mg/L; erythromycin, 0.5 mg/L; and trimethoprim, >16 mg/L. CONCLUSIONS: M. catarrhalis was colonized in 33% of the children aged 6 months to 5 years, and showed low MICs for amoxicillin/clavulanate and oral 2nd and 3rd generation cephalosporins.
Aged ; Amoxicillin ; Anti-Bacterial Agents ; beta-Lactamases ; Cefaclor ; Cefixime ; Cephalosporins ; Child ; Colon ; Drug Resistance ; Erythromycin ; Hospitals, University ; Humans ; Moraxella ; Moraxella (Branhamella) catarrhalis ; Nasopharynx ; Republic of Korea ; Respiratory Tract Diseases ; Trimethoprim