Upala srednjeg uha [Middle ear infection]

Maričić, Martina and Bošnjak, Zrinka and Branica, Srećko (2015) Upala srednjeg uha [Middle ear infection]. Liječnički vjesnik, 137 (9-10). pp. 311-8. ISSN 0024-3477

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Abstract

Middle ear infection is one of the most common childhood infections and the leading reason for antibiotic prescriptions. Although the etiological diagnosis is rarely discovered, successful identification of pathogens depends on properly collected sample, chosen method and microbiological analysis made on time. The most common bacterial pathogen is Streptococcus pneumoniae. Others include Haemophilus influenzae, Moraxella catarrhalis and Pseudomonas aeruginosa, known as the most common bacterial pathogen of chronic inflamations. Viral or polimicrobial upper respiratory tract infections often precede this infection. Pneumococcal conjugate vaccines given during infancy decrease rates of acute middle ear inflammation. It is a self-limited disease with rare complications. The best treatment is watchful waiting for two days followed by amoxicillin during 7 days, only if it is necessary. If there is resistance, then combination of amoxicillin and beta lactamase inhibitor is second line. The best choice for patients allergic to penicillin are macrolides. Antibiotic treatment has contributed to frequent relapses and increase of multi-drug resistant pathogens by permitting their colonization, which eliminates protective nasopharyngeal flora.

Abstract in Croatian

Upala uha jedna je od najčešćih dječjih infekcija zbog koje se propisuju antibiotici. Premda se etiološka dijagnoza ne postavlja često, uspjeh identifikacije uzročnika ovisi o ispravnom uzimanju uzorka, odabiru metode i pravodobnoj mikrobiološkoj analizi. Najčešći bakterijski uzročnik je Streptococcus pneumoniae. Ostali uključuju Haemophilus influenzae, Moraxellu catarrhalis i P. aeruginosu, najčešćega bakterijskog uzročnika kronične upale. Akutnoj upali uha često prethode višestruke infekcije gornjega respiratornog trakta, virusne ili polimikrobne etiologije. Stoga su konjugirana cje­piva primijenjena u dječjoj dobi korisna u smanjenju incidencije bolesti. Akutna upala uha većinom je samolimitirajuća s rijetkim komplikacijama. Najefikasnija terapija je dvodnevno promatranje i naknadna primjena amoksicilina tijekom 7 dana samo ako je potrebno. Ako postoji rezistencija, primjenjuje se kombinacija amoksicilina s laktamskim inhibitorom, dok su makrolidi izbor kod alergije na penicilin. Česti recidivi i rezistencija na antibiotike posljedica su njihove široke primjene, koja pospješuje kolonizaciju patogena čime se mijenja protektivna fiziološka flora sluznice nazofarinksa.

Item Type: Article
MeSH: Acute Disease ; Anti-Bacterial Agents/therapeutic use ; Global Health ; Humans ; Incidence ; Otitis Media/diagnosis ; Otitis Media/drug therapy ; Otitis Media/epidemiology
Departments: Katedra za otorinoloringologiju s audiologijom i fonijatrijom
Depositing User: Anja Majstorović
Status: Published
Creators:
CreatorsEmail
Maričić, MartinaUNSPECIFIED
Bošnjak, ZrinkaUNSPECIFIED
Branica, SrećkoUNSPECIFIED
Date: September 2015
Date Deposited: 19 Mar 2019 07:52
Last Modified: 19 Jun 2019 05:54
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/3145

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