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)

Cefuroxime axetil is a beta-lactamase-stable, second-generation, oral cephalosporin that penetrates sinus tissue in concentrations exceeding the MIC90 values (the minimum concentration of drug needed to inhibit the growth of 90% of an isolate of a particular microorganism) for pathogens most commonly associated with acute sinusitis, including Streptococcus pneumoniae and Haemophilus influenzae. A review of all clinical data published to date demonstrates that cefuroxime axetil has been evaluated in the treatment of acute sinusitis and acute exacerbations of chronic sinusitis ("acute-on-chronic sinusitis") in 18 clinical trials involving 1516 assessable patients. In 12 randomized, comparative trials, the rates of satisfactory clinical outcomes (cure or improvement, 79% to 100%) and bacteriologic eradication (84% to 100%) reported with the use of 250 mg of cefuroxime axetil twice daily were similar to those observed with the use of amoxicillin, amoxicillin/clavulanate potassium, cefaclor, cefadroxil, cefixime, clarithromycin, and doxycycline. In these comparisons, no antibiotic demonstrated any therapeutic advantages over cefuroxime axetil regarding time to symptom abatement. Cefuroxime axetil was at least as well tolerated as the other antibiotics. Overall, the role of cefuroxime axetil in the treatment of sinusitis appears to be as one of the broad-spectrum antibiotics that can be used for infections due to the most commonly implicated sinus pathogens, especially those due to the increasing number of relatively penicillin-resistant strains of S pneumoniae and beta-lactamase-producing strains of H influenzae and Moraxella catarrhalis.
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PMID:Cefuroxime axetil in the treatment of sinusitis. A review. 799 39

Changes in susceptibilities to oral antimicrobials were investigated in 189 children, in whom Haemophilus influenzae was detected by nasopharyngeal culture, among the children who were diagnosed as having acute otitis media or chronic sinusitis with acute exacerbation in the Department of Otolaryngology in 1986, 1988 and 1991. The minimum 50% inhibitory concentration (MIC50) and minimum 90% inhibitory concentration (MIC90) of ampicillin (ABPC), cefaclor (CCL) and erythromycin (EM) in the subjects examined in 1986 were almost the same as the levels in those examined in 1991. The MIC50 level of minocycline (MINO) in the subjects examined in 1991 was lower by 2 test tubes than that determined in 1986, showing improvement in susceptibilities. The prevalence of resistance to antimicrobials was compared between 1986 and 1991. The prevalence to ABPC tended to decrease very slightly, while the prevalence to CCL tended to increase very slightly. The prevalence of EM tended to increase slightly. Many CCL-resistant strains detected in 1991 showed resistance to ABPC and EM, but showed favorable susceptibilities to cefixime and norfloxacin. Future trends of CCL-resistant strains should be carefully observed. There was no marked change in the prevalence of resistance to ABPC or CCL. ABPC and CCL were considered to be the first choice drugs, even at present, for pediatric patients with acute otitis media due to infection with H. influenzae and in those with acute exacerbation of chronic sinusitis due to the infection.
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PMID:[Antimicrobial susceptibilities of Haemophilus influenzae isolated from the nasopharynx of children]. 808 50

The efficacy and safety of cefixime, the first oral third-generation cephalosporin, were evaluated in a multicenter clinical trial involving 118 adult patients with acute sinusitis or acute exacerbations of chronic sinusitis. Patients received a single daily dose of 400 mg of cefixime for a mean duration of 10 days; 106 patients completed a course of therapy. Clinical cure and improvement were achieved in 90% of these patients (61% cured and 29% improved). Among the patients evaluated again 2 weeks after therapy, 91% had a sustained clinical cure or improvement. Sinus exudate specimens were obtained from all patients by transantral puncture before therapy. Pathogens were isolated from 76 patients (66%), the most common pathogens being Haemophilus influenzae, alpha-hemolytic streptococci, and Streptococcus pneumoniae. Eighty-six percent of pathogens were presumed eradicated. Three patients discontinued therapy because of side effects. The most frequently reported adverse effects were gastrointestinal, with 20% of patients reporting diarrhea. Cefixime was effective in the treatment of bacterial sinus infections in adults and was well tolerated.
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PMID:Evaluation of cefixime in the treatment of bacterial maxillary sinusitis. 845 74

A multicentric study was conducted to evaluate the clinical efficacy and tolerance of ofloxacin in the treatment of chronic sinusitis and chronic otitis (CSOM) in outpatients. Two hundred milligrams of ofloxacin was administered twice a day orally for 12 days in 198 patients with chronic sinusitis and 215 patients with CSOM. Cultures for bacteriology were carried out before treatment. The spectrum of pathogens sensitive to ofloxacin included Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis and Haemophilus influenzae. Higher concentrations of ofloxacin were obtained at sites of infection than in serum. Favorable results were achieved clinically in 93.7% of chronic sinusitis cases and 93.9% of CSOM cases. Adverse effects occurred in only 4.1% of cases. These results support the use of ofloxacin as the drug of first choice in the treatment of chronic sinusitis and CSOM in adult outpatients.
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PMID:Effectiveness and safety of ofloxacin in chronic otitis media and chronic sinusitis in adult outpatients. 847 79

There exists no real controversy about the role of aerobic bacteria in acute sinusitis and in acute otitis media. The "infernal trio" Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are by far the most common pathogens in these acute infections. On the contrary, there is still much debate about the normal flora of the paranasal sinuses and the middle ear, although there are some reports of the presence of anaerobes and aerobes in the majority of the normal paranasal sinuses. In chronic sinusitis bacteriological cultures show a greater variation than those in acute sinusitis. Nonetheless, it is demonstrated in most studies that besides the "infernal trio" additional bacteria are present, including anaerobes and gram negative bacteria. In otitis media with effusion (OME) we find the same bacteria as in acute otitis media (AOM) and a pathologic flora in the nasopharynx seems to be important for both AOM and OME. In chronic otitis cultures are nearly always positive and reveal Pseudomonas species, Klebsiella pneumoniae, Staphylococcus aureus, Proteus species and anaerobes.
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PMID:The microbiology of acute and chronic sinusitis and otitis media:a review. 847 83

Trends in the detection of causative pathogens and changes in bacterial counts in patients with sinusitis treated between January 1989 and December 1993 were investigated. In adult patients with chronic sinusitis, Staphylococcus aureus (S. aureus), coagulase negative staphylococci (CNS), Streptococcus pneumoniae (S. pneumoniae), Corynebacterium sp., Haemophilus influenzae (H. influenzae), and Moraxella catarrhalis were often isolated while Pseudomonas aeruginosa (P. aeruginosa) and anaerobic bacteria were detected in 2.4% and 5.3% of patients, respectively. The bacteria isolated from adult patients with acute sinusitis and pediatric patients with either acute or chronic sinusitis were somewhat different from those of adult chronic sinusitis. No bacteria could be isolated from 5.8% of adult chronic sinusitis patients, 8.1% of adult acute sinusitis patients, and 3.1% of pediatric sinusitis patients. The detection rate for anaerobic bacteria has been rising in chronic sinusitis patients owing to improved detection techniques in recent years, while there has been no appreciable change in the isolation rate for other types of bacteria. When the pathogenicity of isolated bacteria was determined based on the amount of bacterial colonization it was found that P. aeruginosa, S. pneumoniae, H. influenzae, and S. aureus were significant as causative pathogens in sinusitis, while CNS.
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PMID:Recent trends in clinical isolates from paranasal sinusitis. 890 70

Management of the patient with otitis media, sinusitis or pharyngotonsillitis is based on information about the host, the organism and the antimicrobial agent. Otitis media (OM) is a common infection in children but selected children have recurrent and chronic OM. The predominant organisms responsible for OM are Streptococcus pneumonia, Haemophilus influenzae and Moraxella catarrhalis. Changes in the antimicrobial susceptibility govern the choice of antimicrobial agents. Surgical treatment should be considered if the child has persistent hearing loss in both ears. Sinusitis shares with OM similar pathogenesis, microbiology and choices of antimicrobial therapy. Endoscopic surgery is the treatment of choice for chronic sinusitis. Pharyngitis may be either viral or bacterial in origin. Penicillin remains the treatment of choice for bacterial pharyngotonsillitis. In patients with recurrent infection, the emergence of B-lactamase producing strains has to be considered and erythromycin or oral cephalosporins might be indicated.
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PMID:Upper respiratory tract infections - otitis media, sinusitis and pharyngitis. 891 62

We studied the clinical efficacy of roxithromycin (RXM) administered at the daily dosage of one tablet (150 mg) for 3 months in 30 patients with chronic sinusitis. The effectiveness of this drug was evaluated on a four-point scale. Subjective and objective symptoms disappeared or decreased markedly, especially postnasal drip and nature of discharge in 80 percent or more of the patients. All symptoms significantly decreased (P < 0.001; headache P < 0.05), except for the sensation of foul odor. Symptoms improved even in those cases in which Haemophilus influenzae was detected. It is suggested that RXM produce some clinically beneficial effect through an immunological and or anti-inflammatory mechanisms in addition to its antibiotic effect.
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PMID:Clinical effect of low-dose, long-term roxithromycin chemotherapy in patients with chronic sinusitis. 905 33

The authors, on the basis of 140 cases, analyze the bacterial flora of essentially chronic rhino-sinusitis observed in hospital consultations at the Pellegrin Hospital, the referral centre of the Aquitaine region. Samples taken in the operating theatre from 100 cases, by aspiration and mucosal biopsy, were studied in aerobic and anaerobic media. The results marked by the scarcity of sterile samples and of anaerobic germs, evidence the predominance of an aerobic flora, with in particular Haemophilus influenzae, Staphylococcus aureus and beta-hemolytic Streptococci. No significant difference was recorded between the bacteriology of acute sinusitis as against chronic sinusitis. The flora of sinusitis appear to depend more on the age factor than on the pathogenic type. Branhamella catharralis is present only in patients under 30. The enterobacteria appear in the adult 30-50 year-old age group and, as from the age of 50, are combined by Pseudomonas aeruginosa, which account for 18% of the strains. These two types of germs then appear to be predominant over the Staphylococci and the Haemophilus.
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PMID:[Bacteriology of the nose and sinuses]. 910 23

This study was designed to study the bacteriology of the ethmoid sinus in chronic sinusitis with a new sampling method to decrease nasal contamination. The anterior nose was disinfected with povidone-iodine solution. Then, the sample of ethmoid sinus was obtained with a cotton-tip stick through a cannula that was put into the ethmoid cavity after removing ethmoid bulla. Thirty-nine patients of chronic sinusitis were included with a total of 69 specimens. Fifty-eight bacterial isolates were recovered. The cultural rate was 60.9%. The most frequently isolated bacteria were Streptococcus viridans, Klebsiella pneumoniae, Proteus mirabilis, and Hemophilus parainfluenzae. Conversely, only three isolates of Staphylococcus epidermidis were obtained. The results show that the new sampling method used in this study could decrease the chance of nasal contamination and might, at the same time, make the study of the bacteriology of the ethmoid sinus more accurate.
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PMID:Bacteriology of ethmoid sinus in chronic sinusitis. 912 55


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