Ceftazidime for outpatient parenteral antibiotic therapy (OPAT) of chronicsuppurative otitis media due to Pseudomonas aeruginosa

The number of patients receiving parenteral antibiotic therapy outside the hospital (OPAT) is growing rapidly, not only because of financial considera tions, but also to limit the risk of nosocomial infections, hospitalization trauma, and to improve the quality of life. The same benefits of OPAT have recently been extended to pediatric patients. In the present study, the efficacy and safety of OPAT was evaluated in 52 c hildren (age range 6-12 years) affected by chronic suppurative otitis media (CSOM) whose parents were deemed compliant. Otorhinolaryngologists and inf ectious disease specialists (IDS) cooperated in diagnosing, managing patien ts and being available 24 hours a day for family consultation. Bacteriologi cal examination of ear exudate was carried out before antibiotic treatment. For all 52 children the infection was caused by Pseudomonas aeruginosa in vitro sensitive to ceftazidime. Ceftazidime was administered at the dosage of 500 mg b.i.d. i.m. at the patient's home according to a self administrat ion model for 7-10 days. All patients returned every other day during the t reatment course for clinical observation and cleansing of the ear, and 30 d ays after the end of the treatment (follow-up). Complete clinical cure and bacteriological eradication were observed in 35 patients (67%), clinical im provement in 12 (23%). No side-effects or hearing impairment were reported at clinical and audiometric check-ups; compliance was absolute. Our data su ggest that children affected by CSOM can be managed as outpatients by a coo perative team of otorhinolaryngologists and IDS.