Effect of amoxycillin with or without clavulanate on adenoid bacterial flora

The effect of antimicrobial therapy with amoxycillin (AMX) or co-amoxiclav (AMC) on the adenoid bacterial flora of 45 children with recurrent otitis m edia (ROM), scheduled for elective adenoidectomy, was studied. Patients wer e randomized before surgery into three groups of 15, having had either no a ntibiotic therapy (control), or 10 days of therapy with AMX or AMC. Core ad enoid tissues were quantitatively cultured for aerobic and anaerobic bacter ia. Polymicrobial aerobic-anaerobic flora was present in all instances. The predominant aerobes in all groups were ei-haemolytic and non-haemolytic st reptococci, Haemophilus influenzae, Staphylococcus aureus, group A beta -ha emolytic streptococci and Moraxella catarrhalis. The prominent anaerobes we re Peptostreptococcus spp., Prevotella spp. and Fusobacterium spp. The numb er of isolates was significantly reduced in those treated with AMX (110; P < 0.05) or AMC (54; P < 0.001) compared with control (148). The number of b acteria per gram of tissue was lower in those treated with both antibiotics . The number of potential pathogens was lower in those treated with AMC com pared with the other two groups (P < 0.001). The number of beta -lactamase- producing bacteria (BLPB) was lower in those treated with AMC compared with those treated with AMX (P < 0.025) or no antibiotic (P < 0.001). These dat a illustrate the ability of AMX and AMC to reduce the bacterial load as wel l as potential pathogens and BLPB from the adenoids of children with ROM.