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Israeli researchers studied 192 children, 3 to 48 (mean, 10.4) months old, with acute otitis media (AOM) to determine whether some clinically unresponsive AOM cases are, in fact, superinfections caused by antibiotic-resistant S pneumoniae that were present in the nasopharynx prior to antibiotic treatment. Bacteriologic eradication from the nasopharynx (NP) and middle ear fluid (MEF) during AOM by amoxicillin/clavulanate, azithromycin, or TMP/SMZ was prospectively evaluated. All children had NP (only for S pneumoniae) and MEF cultures prior to antibiotic initiation, while 119 children had a second NP and MEF culture 4 to 6 …
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