Bacterial epidemiology in ENT and bronchopulmonary infections 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 a ntibiotics is becoming increasingly frequent, therapeutic strategies must b e revisited. Sinusitis: H. influenzae and S. pneumoniae are the most frequent causal age nts in acute maxillary sinusitis. For chronic sinusitis, beta-lactamase pro ducing 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. in fluenzae and S. pneumoniae, followed by M, catarrhalis, S. aureus, enteroba cteriaceae, 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.