[Aetiology and therapeutic considerations in chronic otitis media. Analysis of a 5 year period]. / Etiología y consideraciones terapéuticas en otitis media crónica. Análisis de un período de 5 años.

BACKGROUND: This study provides an update on the bacterial aetiology of chronic otitis media in our area and the antibiotic sensivity of the bacteria involved in this pathology. METHODS: A retrospective study from 2000 to 2004, is carried out in a total of 127 adults diagnosed of chronic otitis media. Isolated bacteria were tested in vitro regarding sensitivity to fluoroquinolones, aminoglyosides, colistin, oxacilin, amoxicillin-clavulanic acid and cephalosporins. RESULTS: The most common pathogens we found were gram-negative organisms, especially Pseudomonas aeruginosa (47.7%), but among gram positive organisms, Staplhylococcus aureus, was involved in a significant number of infections (21%). The main findings that we found were as follows: 18% of P. aeruginosa strains were resistant to ciprofloxacin and 21.8% S. aureus strains were resistant to levofloxacin. 10.8% of S. aureus strains showed resistance to beta-lactams. CONCLUSION: The most important pathogen in our study was P. aeruginosa along with a variety of other gram-negative organisms and S. aureus. There is growing concern over the use of antibiotics and the development of resistance. We need to evaluate the antimicrobial activity by determining the susceptibility of a particular antibiotic against a specific bacterial strain.

[Antimicrobial therapy in chronic suppurative otitis media]. / Terapéutica antimicrobiana en otitis media crónica supurada.

A randomized study was made of 125 patients with chronic middle ear infection. The most frequently isolated microorganisms were: Pseudomonas aeruginosa, Staphylococcus aureus and Enterobacteriaceae. Ciprofloxacin is very active against the microorganisms usually isolated and it has been shown to provide effective therapy in ear infections. In order to study the effectiveness of ciprofloxacin in chronic otitis media, we selected four different treatment groups: oral ciprofloxacin (500 mg/12 h); 0.5 and 0.2% topical solutions of ciprofloxacin (3 drops/8 h), and oral ciprofloxacin plus 0.2% topical solution. Topical polymyxin and neomycin were used as controls. Topical ciprofloxacin (0.2%) was the most effective regimen of those tested for the treatment of chronic otitis media.

[Beta-lactamase-producing bacteria in recurrent childhood tonsillitis]. / Bacterias productoras de betalactamasa en amigdalitis recurrente infantil.

Beta-lactamase production by the normal pharyngeal flora could account for the failure of penicillin treatment in patients with recurrent tonsillitis. We studied the microbial flora of tonsils from 22 healthy children (control group) and from 40 children with recurrent tonsillitis who were treated with penicillin. Cultures were made before treatment and repeated 15 days after the first culture. Streptococcus pyogenes was recovered in 25% of the patients in the recurrent tonsillitis group. Beta-lactamase producing bacteria were recovered in 100% of children with tonsillitis and in 86.4% of the healthy children. We found a 65% failure rate of penicillin therapy in recurrent tonsillitis. Our results suggest that beta-lactamase production by pharyngeal organisms does not fully explain the failure of penicillin therapy for recurrent tonsillitis.

[Therapeutic possibilities in recurrent infantile tonsillitis]. / Posibilidades terapéuticas en la amigdalitis recurrente infantil.

The present study compares two therapy protocols in 40 children with recurrent tonsillitis. Twenty of them were randomly treated with penicillin, and the remaining 20 received penicillin + metronidazole. Clinical and microbiological assessment of the results was made. The association of penicillin and metronidazole was most efficient, probably due to its activity against Streptococus pyogenes and anaerobic betalactamase-producing bacterias. The high failure rate in the penicillin group states the necessity to change the therapy with this antibiotic in the treatment of childhood recurrent tonsillitis.

[The incorporation of acyclovir into the treatment of peripheral paralysis. A study of 45 cases]. / Incorporación del aciclovir en el tratamiento de la parálisis periférica. Un estudio en 45 casos.

The relation between use of acyclovir and facial nerve palsy prognosis was studied. In a randomised study, steroids or steroids + acyclovir (oral doses for Bell's palsy, and intravenous doses for Ramsay Hunt's syndrome) were given to 45 patients with facial palsy. There was a significant reduction of sequelae in patients treated with acyclovir in the group of Ramsay Hunt's syndrome (n = 15) (p less than 0.05). There were no significant differences in the group of Bell's palsy (n = 30) (p greater than 0.05), treated with acyclovir compared with steroids.

[Changes in the flora of the oral cavity after oral topical antibiotics. Importance in antimicrobial prophylaxis in surgery of the neck and head]. / Análisis de las modificaciones en la flora de la cavidad bucal tras el uso de antibióticos tópicos orales. Importancia en la profilaxis antimicrobiana en cirugía de cabeza y cuello.

A pilot study using 5 healthy adults was performed to assess the influence of topical antibiotics and antiseptics on oral flora. Samples of saliva were cultured before and after rinsing the mouth with several solutions: clindamycin, amoxyciclin + clavulanic, povidone-iodine and placebo. The results of this study suggest that, by reducing concentrations of oral flora, topical oral antibiotic prophylaxis is justified for patients having a high risk of developing a surgical infectious complications.

[Facial paralysis in infancy. Clinical, diagnostic and therapeutic aspects]. / Parálisis facial en la infancia. Aspectos clínicos, diagnósticos y terapéuticos.

We present seven cases of facial paralysis in newborn and infants from a series of 88 patients (pediatrics and non pediatrics) seen in a fourteen months period (October 1987 to December 1988). Current approaches to diagnosis and treatment, including pharmacological treatment with steroids and surgical treatment are described. All patients we present in this paper recovered a good facial activity and no secondary effects were found during treatment.