Acute otitis media caused by antibiotic-resistant Streptococcus pneumoniaein southern Israel: Implication for immunizing with conjugate vaccines

The potential coverage of antibiotic-resistant pneumococci causing acute ot itis media (AOM) by 7-, 9-, and 11-valent conjugate pneumococcal vaccines w as studied in southern Israel. A total of 876 cases of pneumococcal AOM wer e studied in the context of various clinical conditions. Of the isolates, 6 8% were resistant to greater than or equal to 1 drug, 61% were resistant to penicillin, and 13% were resistant to greater than or equal to 3 antibioti c classes. Antibiotic resistance and coverage by the various candidates wer e age and population dependent and were higher among those with a complicat ed clinical course, as indicated by recent antibiotic use and recurrence of AOM. The results suggest that, if efficacious, the conjugate pneumococcal vaccines can substantially reduce the occurrence of pneumococcal AOM in gen eral and complicated pneumococcal AOM in particular.