[Microbial view and optimal antibiotic therapy in acute purulent ENT diseases].

The aim of the study was elaboration of optimal antibiotic treatment in acute pyoinflammatory ENT pathology basing on the results of updated microbial tests and basic rules of microflora suppression by antibiotics. A total of 200 patients were examined. Of them, acute purulent sinusitis was diagnosed in 15, acute purulent otitis media in 25, paratonsillar abscess in 12 cases. Their microflora was studied for antibiotic sensitivity, the ability to form beta-lactamase was evaluated, microbiological examination of the content from purulent foci was made. It was found that the majority of acute purulent ENT diseases were caused by streptococci, gram-negative microorganisms (H. influenzae, M. catarrhalis, Klebsiella spp. et al), staphylococci and obligate anaerobes most of which produce beta-lactamase (up to 79%). From 88 to 100% pathogens were sensitive to amoxicillin/clavulanate, 18-59% -- to cephasoline, lincomycin or ampicillin. The treatment with antibiotics of different groups was assessed by dynamics of clinical symptoms and results of repeated microbiological analyses. The optimal antibiotic to start therapy of patients with acute purulent ENT diseases was amoxicillin/clavulanate in a new form -- 1000 mg (twice a day for 7 days).