This study retrospectively investigated the microbiology and managemen
t of 40 children who suffered from chronic sinusitis. The sinuses infe
cted were the maxillary (15 cases), ethmoid (13), and frontal (seven).
Pansinusitis was present in five patients. All aspirates were culture
d for aerobic and anaerobic bacteria. A total of 121 isolates (97 anae
robic and 24 aerobic) were recovered. Anaerobes were recovered from al
l 37 culture-positive specimens, and in 14 cases (38 per cent) they we
re mixed with aerobes. Twenty-three beta-lactamase-producing bacteria
were isolated from 16 (43 per cent) patients. The 15 patients who rece
ived clindamycin had the most rapid response to therapy and a change o
f therapy and surgical drainage was required in one case. Of the 16 pa
tients who received amoxycillin or ampicillin, 16 responded to therapy
, six needed a change of therapy, including four who also had surgical
drainage. Of the six who were treated with erythromycin, three needed
antibiotic change, two with surgical drainage. Of the three that rece
ived cefaclor, two were cured, and one had an antibiotic change. Resis
tant organisms were recovered in all the cases that required therapeut
ic change. These findings support the important role of anaerobic bact
eria in the polymicrobial cause of chronic sinusitis in children, and
the superiority of therapy effective against these organisms.