Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antimicrobial regimens consisting of a brief initial period of parenteral therapy followed by oral therapy were investigated in infants and children with suppurative bone and joint disease. There were 30 patients with acute hematogenous disease (19 osteomyelitis; three osteoarthritis; eight arthritis) and five with subacute or chronic osteomyelitis. Disease was due to Staphylococcus aureus in 26, Hemophilus influenzae in five, streptococci in three, and S. aureus plus Streptococcus pyogenes in one patient. Pus was removed by surgical drainage or needle aspiration. Oral therapy was monitored by assay of antibiotic concentration and bactericidal activity in serum. Adjustments in dosage were made when necessary to assure a peak serum bactericidal titer of at least 1:8. One patient progressed to chronic osteomyelitis but all other patients with acute disease responded well. Oral therapy provides increased patient comfort and decreases the risk of nosocomial infection associated with prolonged intravenous therapy. It should be carried out only under carefully monitored conditions in hospital to assure compliance and adequacy of serum bactericidal activity.
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PMID:Oral antibiotic therapy for skeletal infections of children. II. Therapy of osteomyelitis and suppurative arthritis. 63 97

From 1977 to 1989, 23 children with sickle cell disease were identified as having 21 episodes of acute and 3 episodes of chronic osteomyelitis, respectively. The responsible organisms were found in 17 cases: Salmonella (12 cases), coagulase-negative Staphylococcus (3 cases). Haemophilus influenzae (1 case), Escherichia coli (1 case). The mean age was 7 7/12 years. In 15 patients, osteomyelitis occurred in 1 bone; osteomyelitis of more than one bone was recorded in 9 cases. The most commonly affected bone was the femur (7 episodes); 5 episodes of hand-foot syndrome with osteomyelitis occurred in children in the first 2 years of life (mean age 16 months). Two patients had a Salmonella vertebral osteomyelitis. Incision and drainage were performed in 5 cases and bone aspiration in 9 cases. Etiologic agents were obtained with these two procedures in respectively 5 and 3 cases. Radionuclide scans were used in 7 episodes: uptake on bone scan was increased in 5 cases and normal in 2. In all cases, the outcome was satisfactory. Differentiation from acute bone infarcts in difficult. An extensive workup is required to confirm the diagnosis of infection: early scintigraphy, bone aspiration or surgical biopsy in patients with negative blood cultures should be performed. Until the results of cultures, the antimicrobial regimen chosen for initial therapy should be broad enough to treat the likely etiologic agents including Salmonella.
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PMID:[Osteomyelitis in patient with sickle cell disease]. 208 44

This study included 107 patients who were given ofloxacin at daily doses of 400-800 mg for 10 days to 12 months for treatment of a variety of infections. 77 patients were given ofloxacin orally and 30 received it intravenously. Infections treated were bronchopneumonia (29), chronic bronchitis with acute exacerbation (15), chronic osteomyelitis with exacerbation (20), soft tissue infections (13), complicated urinary tract infections (7), chronic prostatis with exacerbation (7), malignant external otitis (4), or other infections (12). Pathogens included Pseudomonas aeruginosa (39), Acinetobacter spp. (9), various Enterobacteriaceae (30), Haemophilus influenzae (26), pneumococci (1) and Staphylococcus aureus (4). MICs of ofloxacin ranged from less than 0.06-2 mg/l. Clinically, 69% of the patients were cured, 18% improved and 13% failed to respond. Bacteriologically, pathogens were eradicated in 70%, persisted in 16% and relapsed in 14%. Resistance during therapy developed almost exclusively in P. aeruginosa strains (17.9%). The following adverse reactions were reported: gastrointestinal disturbances (6), rash plus facial oedema (1), abnormal liver function tests (5) and leukopenia (1). It is concluded that ofloxacin is suitable for treatment of a variety of infections, ranging from serious life threatening infections in ICU patients to chronic ones that require prolonged therapy.
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PMID:Clinical experience with parenteral and oral ofloxacin in severe infections. 221 25

Thirty-five patients suffering from soft tissue infections (12), upper UTIs (6), bronchopneumonia (6), septicaemia (2), chronic osteomyelitis (2), intra-abdominal abscess (2), liver abscess (1), lung abscess (1), acute cholangitis (1), thoracic empyema (1) and chronic prostatitis (1) were given imipenem/cilastatin for 6-21 days. In 22 patients several aggravating factors coexisted, while infection in 16 patients was polymicrobial. The following pathogens were implicated: Pseudomonas aeruginosa (21), Escherichia coli (15), Enterobacter cloacae (6), Proteus spp. (3), Klebsiella pneumoniae(3), Citrobacter freundii (1), Salmonella enteritidis (1), Acinetobacter spp. (4), Haemophilus influenzae (2), Bacteroides fragilis (1) and Peptococcus saccharolyticus (1) with MICs to imipenem ranging between 0.5 and 8 mg/l. A successful clinical response was observed in 91.4% of the patients, while pathogens were eradicated in 75.9%, persisted in 24.2% and recurred, in 9.1% of patients, with development of resistance to imipenem in two Ps. aeruginosa strains. Against 150 multiresistant strains of Ps. aeruginosa, 40% of which were resistant to amikacin, 86.4% and 88.9% were found sensitive to ceftazidime and imipenem respectively. It is concluded that imipenem provides the possibility of treating successfully multiresistant and polymicrobial infections with a single antimicrobial.
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PMID:Evaluation of imipenem/cilastatin against nosocomial infections and multiresistant pathogens. 346 91

66 patients were given daily doses of ofloxacin between 400 and 800 mg for 10 days to 6 months. They were suffering from exacerbation of chronic bronchitis (15), soft tissue phlegmon (11), complicated urinary tract infections (7), bronchopneumonia (7), chronic osteomyelitis in exacerbation (8), chronic prostatitis in exacerbation (5), lower urinary tract infections (3), chronic otitis media (3), acute otitis (3), acute bronchitis (1), lung abscess (2) or liver abscess (1). Pathogens included Pseudomonas aeruginosa (24), Haemophilus influenzae (16), Proteus mirabilis (6), Escherichia coli (6), Enterobacter cloacae (6), Providencia stuartii (2), Serratia marcescens (2), Citrobacter diversus (1), Salmonella enteritidis (1), Acinetobacter anitratus (1), Staphylococcus aureus (1) and Streptococcus pneumoniae (1). In 35 patients (53%), several aggravating factors coexisted. MICs of ofloxacin ranged from less than or equal to 0.06 to 2 mg/L. Clinically, 65% of the patients were considered as cured, 17% improved and 18% failed to respond. Bacteriologically, pathogens were eradicated in 62%, persisted in 16% and relapsed in 22%. Adverse reactions included gastrointestinal disturbances (4), rash plus facial oedema (1), abnormal liver function (2) and leucopenia (1).
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PMID:Efficacy and tolerance of oral ofloxacin in treating various infections. 348 12

A survey of the 58 patients with acute osteomyelitis seen in one general hospital between 1969 and 1979 has shown that, although the condition is less common now than in the pre-antibiotic era, it remains a serious disease. Bone pain and tenderness are still the commonest symptoms, but the source of the infection is less apparent now than it used to be, and this may lead to delay in diagnosis. The antecedent trauma experienced by nearly half the patients probably predisposes to infection by causing local bone damage and thus a focus for secondary infection. The pattern of infecting organisms has not changed much over the past 11 years, but Haemophilus influenzae must be considered in children aged under 5 years. Treatment was the use of antibiotics, with surgical drainage if necessary. The commonest antibiotic used was clindamycin, and chronic osteomyelitis did not develop in patients treated with this antibiotic, whereas all 9 patients who had chronic sequelae necessitating sequestrectomy had received cloxacillin either alone or in combination with another antibiotic.
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PMID:Acute osteomyelitis in a district general hospital. 612 Nov 92

Two hundred forty-one children who had osteomyelitis during a 19-year period, 1974 through 1992, were identified by chart review. Acute osteomyelitis or chronic osteomyelitis was the diagnosis for 221 (92%) and 20 (8%) of the children, respectively. Bacteriologic etiology was documented in 137 (57%) of the cases. Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella species organisms, and Haemophilus influenzae type b were isolated from 97 (40%), 10 (4%), 8 (3%), and 7 (3%) of the children, respectively. S. aureus was the predominant microorganism in all age groups, whereas H. influenzae occurred only in children younger than 2 years of age. P. aeruginosa was recovered predominantly from children with a penetrating injury of the foot, while salmonella bone infections were diagnosed in patients with sickle cell disease. These data provide guidelines for the initial work-up for and management of osteomyelitis in children living in developing Latin American countries.
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PMID:Pediatric osteomyelitis in Panama. 798 7

Sickle cell disease is associated with frequent and often severe infections as a result of immune function impairment and functional asplenia. Also, infection can trigger a vasoocclusive crisis. Pneumococcal bacteremia and meningitis are so severe as to warrant prophylactic penicillin therapy, which has provided a dramatic decrease in early mortality. Bacterial pneumonia is common in patients younger than four years, with most cases being due to S. pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydia pneumoniae. Acute chest syndrome is both a difficult differential diagnosis and a common concomitant of bacterial pneumonia. Osteomyelitis is generally due to a salmonella, most often S. enteritidis; multiple foci are common and treatment is difficult, with some patients developing chronic osteomyelitis with sequestration. Parvovirus B 19 infection causes acute bone marrow failure. Malaria does not result in cerebral malaria but can lead to severe anemia or vasoocclusive crisis, and should therefore be effectively prevented. Antimicrobials are generally selected for efficacy against pneumococci (septicemia, meningitis), Salmonella (septicemia, meningitis, osteomyelitis), and mycoplasmas (pneumonia). Prophylactic therapy is of paramount importance and relies on long-term or lifelong penicillin therapy started at four months of age and on closely-spaced immunizations, most notably against pneumococci, the hepatitis B virus, S. typhi, and H. influenzae. Resistant pneumococcal strains have not been reported to cause prophylactic treatment failures. Conjugated pneumococcal vaccines are effective in protecting infants and should therefore be used in sickle cell patients.
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PMID:[Infection and sickle cell anemia]. 1008 75