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Abstract
About 80% of children with chronic OME carry respiratory pathogens in the nasopharynx, with a remarkably stable spectrum and frequency. In a randomized clinical trial the nasopharyngeal flora was determined in 45 untreated cases and in 32 cases treated with cefaclor (Kefolor®), 20 mg/kg body weight b.i.d. for 10 days. Compared to the untreated children, the treated group showed a significantly decreased frequency of Streptococcus pneumoniae and Branhamella catarrhalis, and a reduced number of cultures with mixed pathogens. An approximate quantitative survey showed a decreased growth of Haemophilus influenzae, but the frequency of isolation was unchanged. The results are put in relation to the penetration of cefaclor to adenoid tissue and middle ear effusion in chronic OME.