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)

The study reported here was a nationwide assessment of otitis media (466 patients with acute suppurative otitis media and 476 with chronic suppurative otitis media), sinusitis (447 with acute sinusitis and 426 with chronic sinusitis), acute tonsillitis (724 patients), and peritonsillar abscess (141 patients) performed between November 1998 and March 1999. Eighty university hospitals, 79 affiliated hospitals, and 103 general practitioners participated. Methicillin-resistant Staphylococcus aureus(MRSA) comprised 15.6% of the 786 isolated strains of S. aureus. MRSA was frequently detected in patients with suppurative otitis media, but was uncommon in those with acute tonsillitis or peritonsillar abscess, and it was more common in those who had already been treated than in those who had not, with a significant difference between the groups. Vancomycin (VCM) showed the highest antimicrobial activity against MRSA and no VCM resistance was detected. Penicillin-sensitive Streptococcus pneumoniae(PSSP), penicillin-intermediate-resistant S. pneumoniae (PISP), and penicillin-resistant S. pneumoniae (PRSP) accounted for 49.6%, 28.5%, and 21.9% of the 228 isolated strains of S. pneumoniae, respectively. PISP and PRSP were frequently detected in children aged 5 years or younger. beta-Lactamase was produced by 96 of the 100 strains (96%) of Moraxella (Branhamella) catarrhalis. The 281 strains of Haemophilus influenzae isolated consisted of 199 beta-lactamase-negative, ampicillin-sensitive (BLNASe) strains (70.8%), 65 beta-lactamase-negative ampicillin-resistant (BLNAR) strains (23.1%), and 17 beta-lactamase-producing strains (6.0%). BLNAR strains were frequently detected in pretreated patients. Of these 281 strains of H. influenzae, 214 had nontypable capsules. In conclusion, the major bacterial species showed resistance to beta-lactams, indicating that care should be taken when selecting an appropriate antimicrobial agent.
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PMID:Current status of bacterial resistance in the otolaryngology field: results from the Second Nationwide Survey in Japan. 1267 7

In this multicentre, multinational, comparative, double-blind clinical trial, outpatients with both clinical signs and symptoms and radiographic evidence of acute sinusitis were randomly assigned to receive for 7 days either a twice-daily oral regimen of faropenem daloxate (300 mg) or a twice daily oral regimen of cefuroxime axetil (250 mg). Among 452 patients considered valid for clinical efficacy, faropenem daloxate treatment was found to be statistically equivalent to cefuroxime axetil (89.0% vs. 88.4%-95% CI=-5.2%; +6.4%) at the 7-16 days post-therapy assessment. At 28-35 days post-therapy, the continued clinical cure rate in the faropenem daloxate group was 92.6% and that for the cefuroxime axetil group was 94.9% (95% CI: -6.8%; +1.2%). A total of 148 organisms was obtained in 136 microbiologically valid patients (30.1%). The predominant causative organisms were Streptococcus pneumoniae (47.1%), Haemophilus influenzae (30.1%), Staphylococcus aureus (14.7%) and Moraxella catarrhalis (8.8%). The bacteriological success rate at the 7-16 days post-therapy evaluation was similar in both treatment groups: 91.5% and 90.8% in the faropenem daloxate and cefuroxime axetil groups, respectively (95% CI=-9.2%; +9.5%). Eradication or presumed eradication was detected for 97.3% and 96.3% of S. pneumoniae, 85.0% and 90.5% of H. influenzae, 88.9% and 90.9% of S. aureus and 100.0% and 83.3% of M. catarrhalis in faropenem daloxate and cefuroxime axetil recipients, respectively. At least one drug-related event was reported by 9.5% of the faropenem daloxate-treated patients and by 10.3% of those who received cefuroxime axetil. The most frequently reported drug-related events were diarrhoea (2.2% versus 2.9%), nausea/vomiting (1.5% vs. 0.7%), abdominal pain (0.7% vs 1.5%) and skin reactions (1.5% vs. 1.1%). Overall, faropenem daloxate was at least as effective clinically and bacteriologically as cefuroxime axetil and was well tolerated.
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PMID:Comparison of the efficacy and safety of faropenem daloxate and cefuroxime axetil for the treatment of acute bacterial maxillary sinusitis in adults. 1270 1

A pooled analysis of data from 13 phase III studies of telithromycin in the treatment of community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute sinusitis or group A beta-haemolytic streptococcal pharyngitis and tonsillitis was undertaken. Causative key respiratory tract pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes) were isolated at entry to the studies from cultures of relevant respiratory samples and tested for their susceptibility to telithromycin, penicillin and macrolides (erythromycin A). The combined clinical and bacteriological efficacy of telithromycin at the post-therapy, test-of-cure visit (days 17-24) was assessed in patients from whom a microbiologically evaluable pathogen was isolated at entry. More than 98% of key respiratory pathogens isolated, including penicillin G- and macrolide (erythromycin A)-resistant strains of S. pneumoniae, demonstrated full or intermediate susceptibility to telithromycin in vitro at the breakpoints of < or = 1.0 mg/L (susceptible) and 2.0 mg/L (intermediate) used for the purpose of evaluating the susceptibility of isolates recovered during the clinical trials. Treatment with telithromycin 800 mg once-daily for 5, 7 or 7-10 days resulted in high rates of clinical cure (88.5%) and a satisfactory bacteriological outcome (88.9%), similar to the figures seen with comparator antibacterial agents. Clinical cure and eradication rates were good for all key respiratory pathogens, including penicillin G- and macrolide (erythromycin A)-resistant S. pneumoniae. The results suggest that telithromycin will provide effective empirical therapy for community-acquired upper and lower respiratory tract infections.
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PMID:Clinical and bacteriological efficacy of the ketolide telithromycin against isolates of key respiratory pathogens: a pooled analysis of phase III studies. 1470 83

Acute sinusitis is a common problem in children that is often overlooked. The pathophysiology is related to obstruction of the sinus ostia and mucociliary dysfunction. The predominant pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The diagnosis of acute sinusitis is based on persistent or severe upper respiratory tract symptoms. The routine use of roentgenograms to confirm the diagnosis of uncomplicated sinusitis is not recommended for children 6 years or younger but may be considered for children older than 6 years. Antimicrobial therapy is the cornerstone of management and amoxicillin is the drug of choice for most cases of uncomplicated sinusitis.
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PMID:Acute sinusitis in children: diagnosis and management. 1500 90

Primary care doctors should be cautious in the diagnosis and treatment of sinusitis as acute bacterial sinusitis is currently over-diagnosed and over-treated in primary care practice. The clinical diagnosis of acute bacterial sinusitis is difficult in primary care practice; however, a history of purulent rhinorrhoea, purulent secretions in the nasal cavity on examination, tooth pain, worsening of symptoms following initial improvement, lack of effect of decongestants and an elevated erythrocyte sedimentation rate are supportive evidence of bacterial infection. Patients with symptoms for <7 days are not as likely to have bacterial infection. Acute sinusitis is over-treated in primary care practice for several reasons. Firstly, most cases of acute sinusitis are caused by viral infections and resolve without antibacterial treatment. Secondly, in clinical trials of antibacterial treatment, only about one-half of patients diagnosed with acute bacterial sinusitis by experienced primary care physicians have bacterial infection. Thirdly, antibacterial treatment of acute sinusitis is indicated only in patients with severe symptoms of sinusitis or in patients with moderate symptoms of >7 days duration. Symptomatic treatment is sufficient in patients with mild symptoms. Three recent meta-analyses have concluded that newer and broad-spectrum antibacterials are not significantly more effective than narrow-spectrum agents, such as amoxicillin or phenoxymethylpenicillin (penicillin V). However, because of the rapid increase in antibacterial resistance of Streptococcus pneumoniae and Haemophilus influenzae, treatment must take into account current recommendations for treating infections caused by these organisms. Fourthly, sinus imaging studies are not recommended in routine diagnosis but may be helpful in selected cases. Finally, other than pain medication, there is little evidence that use of adjunctive treatments, such as decongestants, is effective in symptom relief. However, a recent study in patients with recurrent sinusitis demonstrated that patients who received fluticasone propionate in addition to antibacterials had a higher rate of clinical success than did patients receiving placebo and antibacterials.
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PMID:Acute sinusitis: guide to selection of antibacterial therapy. 1505 37

This review examines the issues surrounding short-course antibiotic therapy of acute sinusitis. Acute bacterial sinusitis is a common community-acquired infection defined as inflammation of one or more paranasal sinuses, most often the maxillary sinus. It is estimated that 0.5-5% of colds are complicated by acute sinusitis. Up to 1 in 20 upper respiratory tract infections is complicated by bacterial sinusitis, most often caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus. Early diagnosis and appropriate antibiotic therapy, in combination with agents that relieve nasal congestion, are important factors in preventing suppurative complications. Left untreated, it could lead to the development of chronic sinusitis or epidural or subdural empyema, brain abscess, or cavernosus sinus thrombosis. Isolation of the causal organism is often lacking in the community setting. Empiric antibiotic therapy should provide adequate coverage against the most important pathogens. Guidelines from different specialist societies based on current scientific knowledge are helpful in making the decision on which drug to use. Recommendations for duration of treatment of acute sinusitis are inconsistent between different guidelines but usually a 10- to 14-day treatment course is recommended.Recognition that the 10- to 14-day duration of therapy is not derived from a strong scientific or medical rationale has led some clinicians to call for shortening the duration of antibiotic therapy for patients with upper respiratory tract infections. Accumulating evidence suggests that short-course (< or =5 days) antibiotic therapy may have equivalent or superior efficacy compared with traditional longer (10-14 days) therapies and offers a number of advantages. Results of a number of clinical trials investigating 5-day therapy with oral cephalosporins, new quinolones or ketolides in acute (presumed) bacterial sinusitis in comparison with traditional 10-day treatment courses have been published demonstrating equivalent efficacy of 5-day and 10-day regimens. The evidence reviewed in this article strongly supports reduction of the traditional 10-day course of antibacterial therapy to a 5-day course for uncomplicated acute maxillary sinusitis in adults. Further research related to the duration of antibacterial therapy for sinusitis is needed in children and in adult patients with frontal, ethmoidal and sphenoidal sinusitis.
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PMID:Short-course therapy for acute sinusitis: how long is enough? 1560 17

A prospective study of throat cultures and maxillary sinus aspirates from children with chronic sinusitis (n = 21), acute sinusitis (n = 28) or a clinical diagnosis of chronic adenoiditis (n = 41) was performed. Seventy-two bacterial pathogens were isolated from sinus aspirates from 52% of the study population. Haemophilus influenzae was most common pathogen, followed by Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and group A streptococci. Quantitative throat cultures had positive predictive values of 41%, 53% and 75% for H. influenzae, Strep. pneumoniae and M. catarrhalis, respectively, while negative predictive values were 93-98%, indicating that these three pathogens do not cause sinusitis when absent from the throat.
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PMID:Microbiology of sinusitis and the predictive value of throat culture for the aetiology of sinusitis. 1581 70

Sinusitis generally develops as a complication of viral or allergic inflammation of the upper respiratory tract. The bacterial pathogens in acute sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, while anaerobic bacteria and Staphylococcus aureus are predominant in chronic sinusitis. Pseudomonas aeruginosa has emerged as a potential pathogen in immunocompromised patients and in those who have nasal tubes or catheters, or are intubated. Many of these organisms recovered from sinusitis became resistant to penicillins either through the production of beta-lactamase (H. influenzae, M. catarrhalis, S. aureus, Fusobacterium spp., and Prevotella spp) or through changes in the penicillin-binding protein (S. pneumoniae). The pathogenicity of beta-lactamase-producing bacteria is expressed directly through their ability to cause infections, and indirectly through the production of betalactamase. The indirect pathogenicity is conveyed not only by surviving penicillin therapy, but also by 'shielding' penicillin-susceptible pathogens from the drug. The direct and indirect virulent characteristics of these bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections. The antimicrobials that are the most effective in management of acute sinusitis are amoxycillin-clavulanate (given in a high dose), the newer quinolones (gatifloxacin, moxifloxacin) and the second generation cephalosporins (cefuroxime, cefpodoxime, cefprozil or cefdinir). The antimicrobials that are the most effective in management of chronic sinusitis are amoxycillinclavulanate, clindamycin and the combination of metronidazole and a penicillin.
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PMID:Microbiology and antimicrobial management of sinusitis. 1594 76

Aspirates from 26 acutely and 17 chronically infected ethmoid sinuses were studied. Thirty-seven aerobes and 10 anaerobes were recovered from isolates from patients with acute sinusitis. Streptococcus pneumoniae and Haemophilus influenzae were predominant. Twenty-seven aerobes and 41 anaerobes were found in isolates from patients with chronic sinusitis. The predominant isolates were anaerobic gram-negative bacilli and Peptostreptococcus spp.
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PMID:Bacteriology of acute and chronic ethmoid sinusitis. 1600 Apr 83

Clinical practice guidelines for the management of acute sinusitis in children have been published by the American Academy of Pediatrics. Of note is that in this document, a brief discussion of chronic disease concluded that the pathogenesis and management are essentially unknown. Although there are insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of the literature and clinical experience of experts who manage pediatric chronic sinusitis is presented in an effort to develop specific recommendations and to offer practical treatment options. Factors associated with chronic sinusitis should be addressed individually and include recurrent viral upper respiratory infections, allergic and nonallergic rhinitis, ciliary dyskinesia, cystic fibrosis, immunodeficiency, and anatomic abnormalities. Bacteriology includes the 3 pathogens associated with acute disease i.e., Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis but with chronic sinusitis also includes Staphylococcus aureus, anaerobic bacteria, and fungi. Medical interventions discussed include endoscopic sinus surgery, saline nasal irrigation, intranasal decongestant therapy, intranasal steroids, and oral antibiotics. Clinical ranking without regard to side effects and cost suggests that endoscopic sinus surgery and antral irrigation have the highest probability of substantial symptom improvement. Other issues discussed include identification and management of gastroesophageal reflux disease (GERD), allergy, and immune deficiency.
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PMID:Chronic sinusitis in children. 1601 92


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