[Epidemiology of bacterial ENT and bronchopulmonary infection in 1998].

EMPIRICAL STRATEGY: Antibiotic therapy of upper and lower respiratory tract infections is based on an empirical strategy. However, arguments favoring the probability of a given bacteria may be lacking and, since resistance of Streptococcus pneumoniae and Haemophilus influenzae against conventional antibiotics is becoming increasingly frequent, therapeutic strategies must be revisited. SINUSITIS: H. influenzae and S. pneumoniae are the most frequent causal agents in acute maxillary sinusitis. For chronic sinusitis, beta-lactamase producing anaerobic bacteria, S. aureus and peni-resistant pneumococci and H. influenzae must also be considered. ACUTE EXACERBATIONS OF CHRONIC BRONCHITIS: The main causal agents are H. influenzae and S. pneumoniae, followed by M. catarrhalis, S. aureus, enterobacteriaceae, and beta-hemolytic streptococci. COMMUNITY ACQUIRED PNEUMONIA: There are a wide range of pathogens, half of which are identified in different studies. RESISTANCES: For pneumococci, penicillin resistance is currently evidenced in 48% of the strains. For H. influenzae, 30% of the strains are ampicillin resistant.