Based on this microbiologic information the agents considered first line drugs in the treatment of acute otitis media in Costa Rica remain amoxicillin or TMP-SMX.
The serotype distribution of S. pneumoniae causing pediatric OM in Costa Rica is similar to those reported from developed countries. The current heptavalent pneumococcal conjugate vaccine covers 74% of OM episodes in Costa Rican children.
Overall S. pneumoniae serotype 19F was the most common isolate from the middle ear fluid of Costa Rican children. Beta-lactamase-negative H. influenzae was the most prevalent in the subpopulation of patients with FOM. S. pyogenes was the third most common isolate and M. catarrhalis was uncommon.
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