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JAC Advance Access originally published online on January 16, 2004
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Journal of Antimicrobial Chemotherapy (2004) 53, 399-402
© 2004 The British Society for Antimicrobial Chemotherapy

Antimicrobial resistance in the nasopharyngeal flora of children with acute maxillary sinusitis and maxillary sinusitis recurring after amoxicillin therapy

Itzhak Brook* and Alan E. Gober

Department of Pediatrics, Georgetown University School of Medicine, 4431 Albemarle St. NW, Washington, DC 20016, USA

Received 27 August 2003; returned 14 October 2003; revised 2 November 2003; accepted 7 November 2003

Objective: To investigate the antimicrobial susceptibility of the organisms isolated from the nasopharynx of children who present with acute maxillary sinusitis (AMS) or maxillary sinusitis that recurred (RMS) after amoxicillin therapy.

Methods: Analysis of nasopharyngeal cultures obtained from 70 patients, 42 with AMS and 28 with RMS.

Results: Thirty-eight potentially pathogenic organisms were recovered in 36 (86%) of the children from the AMS group, and 40 were isolated from 26 (93%) of the children from the RMS group. The organisms isolated were Streptococcus pneumoniae (21 isolates), Haemophilus influenzae non-type b (17), Moraxella catarrhalis (15), Streptococcus pyogenes (13) and Staphylococcus aureus (12). Resistance to the eight antimicrobial agents used was found in 34 instances in the AMS group compared to 93 instances in the RMS group (P < 0.005). The difference between AMS and RMS was significant with S. pneumoniae resistance to amoxicillin (P < 0.0025), to co-amoxiclav (P < 0.0025), to trimethoprim–sulfamethoxazole (P < 0.05), to cefixime (P < 0.05), and to azithromycin (P < 0.05), and for H. influenzae to amoxicillin (P < 0.025).

Conclusions: These data illustrate the higher recovery rate of antimicrobial-resistant S. pneumoniae and H. influenzae from the nasopharynx of children who had maxillary sinusitis that recurred after amoxicillin therapy than those with AMS.

Keywords: sinusitis, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, antimicrobial resistance

* Corresponding author. Tel: +1-301-295-2698; Fax: +1-253-981-8709; E-mail: ib6{at}georgetown.edu


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