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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cultures obtained from the middle meatus have been used frequently in the past to direct therapy in patients with acute maxillary sinusitis. However, no convincing data have been published to indicate that middle meatal cultures accurately represent the bacterial flora within the maxillary sinus. The hypothesis of this experiment is that bacteria obtained by directed middle meatal cultures qualitatively and quantitatively correlate with cultures taken by maxillary sinus puncture. Acute sinusitis was induced by injecting 10(8) colony-forming units of bacteria directly into the maxillary sinuses of rabbits in which the ostia were occluded with cotton packs. Eight animals were injected with Staphylococcus aureus, eight with Haemophilus influenzae, and eight with Streptococcus pneumoniae. The packs were removed after 3 days, and specimens were obtained from the middle meatus in the region of the maxillary sinus ostium, and from the maxillary sinus, 1 day later. The contralateral maxillary sinuses of six of the animals were injected with normal saline and served as controls. There was a 100% correlation rate between cultures of specimens obtained from the maxillary sinus and from the middle meatus in all 24 animals. In addition, the quantitative counts from the middle meatus and the maxillary sinus correlated. Control animals showed no bacterial growth from either the middle meatus or the maxillary sinus. These results show that, in an animal model of acute sinusitis, cultures of specimens from the middle meatus reflect the contents of the maxillary sinus.
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PMID:Correlation of middle meatal and maxillary sinus cultures in acute maxillary sinusitis. 912 56

Bacteriology of acute maxillary sinusitis was studied in 569 patients in 16 centers of 6 countries located throughout Europe during 1992-1994 by ENT specialists. Patients with symptoms of acute sinusitis lasting less than 3 weeks with ongoing purulent nasal discharge were included. Diagnosis was verified by sinus x-ray or ultrasonography and a positive aspiration finding in maxillary sinus puncture. One or more pathogens were isolated from the maxillary sinus aspirates of 375 (66%) patients. Fifty-six percent of patients harboured 1 pathogen and 10% multiple pathogenic organisms, respectively. Haemophilus influenzae was the most common pathogen isolated (148 isolates), occurring as a single pathogen in 14% of the patients. The occurrence of H. influenzae was highest in Finnish military hospital patients (43-48%), as compared with the non-military Finnish patients (9-11%) or to patients from other European centers (mean 13%). H. influenzae was more frequently beta-lactamase positive in other European centers (22%) than in Finnish centers (7%). Streptococcus pneumoniae was the most common pathogen isolated in other European centers (20%) but second most common in Finnish centers (13%). Moraxella catarrhalis occurred at quite similar frequency among Finnish centers (9-14%), but clearly less often in other centers (mean 4%). S. aureus, which in acute maxillary sinusitis is regarded as a contaminant from the nasal cavity, was more prevalent in other European centers (12%) than in Finnish centers (4%). In patients with acute maxillary sinusitis reliable bacteriological samples should be taken by antral aspiration directly from the diseased sinus.
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PMID:Bacterial findings in acute maxillary sinusitis--European study. 928

In children, sinusitis is a common, generally uncomplicated, and self limiting disease which drops with age. The diagnosis is difficult because of relatively non specific signs and symptoms that overlap with viral upper respiratory infection and allergy. Plain paranasal sinus radiographs are not adequate, in determining the extent of involvement in recurrent or chronic sinusitis and so CT scan has become the standard. Viral illness appears to be the most common predisposing factor. Immune defects (mainly IG2 and IGA) may exist in a significant percentage of children. The role of allergy seems less important. With advances in the genetic field of cystic fibrosis, genetic factors are advocated in chronic or recurrent sinusitis. The most common bacterial pathogens in pediatric sinusitis patients are SP (Streptococcus Pneumoniae), HI (Hemophilus Influenza) and MC (Moraxella Catarrhalis). Other less frequent bacterial species include group A streptococcus, group C streptococcus, streptococcus viridans, peptostreptococcus, moraxella species and Eikenella corrodens. Respiratory anaerobes are not common. Antibiotics resistant to the action of the beta-lactamase are the cornerstone in medical treatment. In recurrent acute sinusitis prophylactic antimicrobials may be helpful. The indication for surgery remains controversial. To date, we have no prospective studies comparing surgical to medical therapy in order to guide us in deciding surgical indication. It is therefore recommended to follow a conservative track and to limit surgical procedures in children with suppurative complications, nasal obstruction from polyposis or refractory sinusitis aggravating chronic pulmonary disease such as asthma.
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PMID:Chronic sinusitis in children. 944 76

The microbiology of 87 patients admitted to hospital, over a five-year period, with acute sinusitis was retrospectively analysed. Sixty-three patients had one or more of an orbital, intracranial, soft tissue or bony complication. Eighty-four patients had maxillary sinus washouts, while 48 required a surgical procedure to their sinuses, and 33, drainage of an empyema. Streptococcus milleri and Haemophilus influenzae were the commonest organisms isolated from sinus aspirates (44 per cent), with a noticeable absence of Streptococcus pneumoniae (10 per cent). Organisms cultured from intracranial, soft tissue or orbitral empyemas were predominantly Streptococcus milleri (50 per cent) and Staphylococcus aureus (25 per cent) with an absence of Haemophilus influenzae (four per cent) and Streptococcus pneumoniae (four per cent). Ampicillin is an appropriate first line antimicrobial agent in patients with acute complicated sinusitis with the addition of cloxacillin in cases with an empyema. Chloramphenicol or ceftriaxone is used in cases with an intracranial complication.
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PMID:Antibiotic choice in acute and complicated sinusitis. 962 76

The microbiology of infections of the paranasal sinuses can be anticipated according to the patient's age, clinical presentation, and immunocompetence. In acute sinus disease, viral upper respiratory infections frequently precede bacterial superinfection by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Staphylococci and respiratory anaerobes are common in chronic sinus infection, which may also be caused by exacerbations of infection with the bacterial species that cause acute disease. Enterobacteriaceae may be found in patients with nosocomial sinusitis who are predisposed to the development of sinusitis by prolonged nasogastric and nasotracheal intubation. Immunosuppressed patients have episodes of sinusitis caused by the usual agents associated with acute sinusitis in immunocompetent patients, and they may also become infected with a broad array of unusual agents, including mycobacterial species, fungi, and protozoa.
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PMID:Microbiology of acute and chronic sinusitis in children and adults. 967 Oct 39

Pharmacokinetic, bacteriological and clinical studies were performed in pediatrics on tazobactam/piperacillin (TAZ/PIPC), a combined drug of a new beta-lactamase inhibitor tazobactam and piperacillin at a ratio of 1:4. 1. Serum levels and urinary excretions of TAZ, PIPC and desethyl piperacillin (DEt-PIPC), a metabolite of PIPC, after one shot intravenous administration of 50 mg/kg of TAZ/PIPC to two children (6-7 years old) were investigated. The serum TAZ level at 0.08 hour was 50.8-51.0 micrograms/ml after administration. Then TAZ concentrations gradually decreased with half-lives of 0.38-0.45 hour, and reached 1.0-1.4 micrograms/ml after 2 hours and was not detected after 3 hours and 6 hours. Serum PIPC levels at 0.08 hour was 167.0-231.0 micrograms/ml after administration. Then PIPC concentrations gradually decreased with half-lives of 0.41-0.55 hour, and reached 1.2-2.4 micrograms/ml after 3 hours and was not detected after 6 hours. DEt-PIPC was detected slightly in serum. A ratio of TAZ to PIPC was about 1 to 4 in serum at each time. Urinary recovery rates of TAZ in the first 6 hours after administration of TAZ/PIPC were 33.5-90.1% and those of PIPC were 41.9-77.8% and those of DEt-PIPC were 1.5-2.8%. 2. TAZ/PIPC was administered to 27 pediatric patients (their ages ranged between 2 months and 11 years old) with various infections, and clinical and bacteriological effects and adverse reactions were investigated. Single doses were 26.2-55.6 mg/kg, frequencies of administration were 3-4 times a day, and durations of administration were 3 1/3-7 1/3 days, and total dosages were 4.5-33.75 g. Clinical effects were evaluable in 26 cases. Responses were rated as "good" in acute purulent tonsillitis 1 case and acute purulent otitis media 1 case, as "excellent" in acute sinusitis 1 case, as "excellent" in 2 and "good" in 1 out of 3 cases of acute bronchitis, as "excellent" in 13 and "good" 2 out of 15 cases of acute pneumonia, as "excellent" in acute urinary tract infection 2 cases and as "excellent" in acute enteritis in 1 case, acute appendicitis in 1 case and lymphadentis in 1 case. In all cases, the results were rated as "good" or "excellent". Antimicrobial effects against a total of 10 strains identified or assumed to be pathogenic bacteria were evaluated. The 10 strains of bacteria included 4 strains of Streptococcus pneumoniae, 3 strains of Haemophilus influenzae (2 strains beta-lactamase producing), 2 strains of beta-lactamase producing Moraxella catarrhalis, 1 strain of beta-lactamase producing Morganella morganii. All the bacteria listed here were judged to have been eradicated. Adverse reaction was observed in 1 case with mild diarrhea. As abnormal changes in laboratory data, leucocytopenia in 1 case, elevation of GOT. GPT in 2 cases and eosinophilia in 1 case were observed. On the basis of the findings, TAZ/PIPC was considered to be effective and safe in the treatment of pediatric infections.
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PMID:[Pharmacokinetic, bacteriological and clinical evaluation of tazobactam/piperacillin in pediatrics]. 969 67

The clinical efficacy of cefditoren pivoxil (CDTR-PI) was evaluated for 43 pediatric patients with acute otitis media or acute sinusitis. The causative organisms were identified and their susceptibilities to 6 oral beta-lactam antibiotics were measured; ampicillin (ABPC), cefaclor (CCL), cefdinir (CFDN), cefditoren pivoxil (CDTR-PI), cefteram pivoxil (CFTM-PI) and cefpodoxime proxetil (CPDX-PR). The ages of 43 patients were distributed from 4 months to 10 years and 7 months, and especially children under 4 years accounted for 72% (31 cases). In 22 cases (51%), Haemophilus influenzae or Streptococcus pneumoniae were identified as the pathogens, but in 18 cases, no causative organisms were defined. Treatment by CDTR-PI was successful in 12 cases out of 15 evaluable cases in which H. influenzae or S. pneumoniae were identified as the main causative organisms. From the susceptibility testing of them, some strains of H. influenzae were found to be ABPC-resistant and some strains of S. pneumoniae were benzylpenicillin (PCG)-resistant. To support above clinical evaluation of CDTR-PI, susceptibility testings on clinically isolated H. influenzae (81 strains) and S. pneumoniae (79 strains) were performed using above mentioned 6 oral beta-lactam antibiotics. The MIC80s against H. influenzae were; CDTR-PI 0.06 microgram/ml, CCL 2 micrograms/ml, CPDX-PR 0.125 microgram/ml, CFTM-PI 0.03 microgram/ml, CFDN 1 microgram/ml and ABPC 1 microgram/ml. Those against S. pneumoniae were; CDTR-PI 0.5 microgram/ml, CCL > 4 micrograms/ml, CPDX-PR 2 micrograms/ml, CFTM-PI 1 microgram/ml, CFDN 2 micrograms/ml and ABPC 1 microgram/ml. From those results, it was concluded that CDTR-PI or CFTM-PI may be preferable for the treatment of acute otitis media and acute sinusitis in children.
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PMID:[Causative organisms of acute otitis media and acute sinusitis in children and their susceptibility of oral beta-lactam antibiotics]. 1022 Nov 81

Sinusitis is a common disorder in both children and adults. It is responsible for significant absenteeism from school and work. Up to 10% of upper respiratory infections in children are complicated by acute sinusitis. Since antibacterial therapy is most often empirically chosen to treat the disorder, knowledge of the typical etiologic agents as well as awareness of the antibacterial susceptibility profiles in a given community are of paramount importance. The need for consistently bactericidal antibacterials, the recognition of the importance of nontypable Hemophilus influenzae unresponsive to first-generation cephalosporins, tetracyline-resistant Gram-positive cocci, and the increasing emergence of beta-lactamase-positive respiratory pathogens such as H. influenzae and Moraxella catarrhalis, now mandate the use of newer therapeutic agents for acute and chronic sinusitis.
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PMID:Antibacterial management of acute and chronic sinusitis. 1034 92

Sinusitis is a prevalent and costly disease that affects >14% of the population and accounts for >$2 billion in yearly healthcare costs. It is one of the most common conditions treated by primary care physicians. The multiple host and environmental factors that contribute to the pathogenesis of the disease and the lack of clear guidelines for diagnosis and treatment pose a challenge to effective management of the problem. The diagnosis of uncomplicated cases rests mainly on the history and clinical examination; attempts have been made to identify the most useful clinical predictors of acute bacterial sinusitis. Microbiologic and imaging studies are rarely performed during the initial assessment and are usually reserved for recurrent or refractory disease. Treatment involves drainage of the congested sinuses and elimination of pathogenic organisms. Although antimicrobial therapy hastens the resolution of symptoms of acute sinusitis, the need for antimicrobial therapy remains questionable, and its judicious use is challenged by the increase in antibiotic-resistant Haemophilus influenzae and Streptococcus pneumoniae, the organisms most commonly implicated in acute sinusitis. A lack of resolution or frequent recurrence of sinusitis warrants evaluation by a specialist.
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PMID:A focus on acute sinusitis in adults: changes in disease management. 1034 62

The pharmacotherapeutic options for acute sinusitis in children are reviewed. Acute sinusitis occurs more frequently in children than in adults. The diagnosis is based primarily on clinical signs and symptoms. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the organisms most frequently implicated. A variety of antimicrobials have FDA-approved labeling for use in the treatment of sinusitis. In randomized, controlled clinical trials identified in a MEDLINE search for the period from 1966 to 1999, amoxicillin had efficacy similar to that of amoxicillin-clavulanate, azithromycin, cefuroxime, and clarithromycin in treating acute sinusitis in children. Azithromycin was effective as a three-day course of treatment. Amoxicillin and cefuroxime are better tolerated than most antibiotics; azithromycin and clarithromycin are also well tolerated. Amoxicillin-clavulanate tends to cause more gastrointestinal symptoms than amoxicillin and is more expensive. Azithromycin is more expensive than amoxicillin but less expensive than other broad-spectrum antimicrobials. Amoxicillin remains the drug of first choice for treating acute sinusitis in children. It has been found to be as effective as other broad-spectrum agents, better tolerated, and less expensive.
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PMID:Pharmacotherapy of acute sinusitis in children. 1076 20


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