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)

Opsonization of nontypeable Haemophilus influenzae with antibody is critical for the interaction between the organism and human polymorphonuclear leukocytes (PMNs). Nontypeable H. influenzae opsonized in fresh antibody-positive serum induced the release of 42.5 +/- 17.9 ng of leukotriene B4 per ml from PMNs after 20 min of incubation at 37 degrees C. On the other hand, opsonization of the organisms in fresh antibody-negative serum stimulated the release of significantly smaller amounts of leukotriene B4 by the PMNs. Simultaneous determinations of phagocytosis demonstrated similar patterns of response. A small amount (26.7 +/- 7.6%) of unopsonized nontypeable H. influenzae was phagocytosed by PMNs during 20 min of incubation at 37 degrees C. In contrast, 89.3 +/- 2.0% of nontypeable H. influenzae opsonized in fresh antibody-positive serum was phagocytosed during the same incubation period (P less than 0.001). Removal of complement through heat inactivation at 56 degrees C for 30 min did not significantly affect phagocytosis. These data suggest that the humoral immune response to nontypeable H. influenzae plays an important role in the inflammatory process and may contribute to the production of middle ear effusions in otitis media.
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PMID:Release of leukotriene B4 from human neutrophils after interaction with nontypeable Haemophilus influenzae. 165 84

The effect of prior antibiotic treatment on the course of otitis media was assessed in a group of 62 children who experienced 83 episodes of ear infection during 3 years of observation. Bacterial quantitation in middle ear fluids demonstrated a significantly higher colony count in symptomatic children (3.9 x 10(4) +/- 12 bacteria per milliliter) compared to asymptomatic children (6.3 x 10(3) +/- 10 bacteria per milliliter; p = .05). Bacterial counts similarly tended to be higher in children with Streptococcus pneumoniae (4.0 x 10(6) +/- 16 bacteria per milliliter) and Hemophilus influenzae (2.0 x 10(6) +/- 16 bacteria per milliliter), who were more often symptomatic (73% and 55%, respectively, versus 38%) than children with Moraxella catarrhalis (7.9 x 10(3) +/- 2). Antibiotic therapy between 3 and 30 days prior to bacterial diagnosis was associated with a reduction in symptoms from 70% to 38% (p less than .025). However, prior treatment did not statistically reduce bacterial colony counts, although S pneumoniae decreased 90% in the previously treated group. Resistance to ampicillin occurred in 0% of S pneumoniae, 39% of nontypeable H influenzae, and 80% of M catarrhalis subjects without prior treatment and in 0%, 46%, and 100%, respectively, of subjects previously treated (p less than .025). These data suggest that prior treatment has a significant impact on the subsequent course of otitis media in children.
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PMID:Effect of prior antibiotic treatment on middle ear disease in children. 172 91

The strategy of antimicrobial therapy in acute otitis media rests on bacteriologic and pharmacokinetic data. Pneumococci and Haemophilus are still the two most prevalent pathogens in acute otitis media and raise problems regarding susceptibility: 25% of Haemophilus beta-strains produce beta-lactamases and 6 to 12% of pneumococci are intermediate or resistant to penicillin. Pharmacologic features required of antimicrobials used in acute otitis media include good penetration in the ear and sustained supra-MIC levels in middle ear fluid. Kinetics of drugs in the ear are still often incompletely understood. The last selection criterion is analysis of comparative trials. Available data do not point to superiority of any drug over the others. Amoxicillin should no longer be given as first-line therapy. Amoxicillin combined with clavulanic acid (Augmentin) is effective on the entire spectrum of causative organisms. Higher levels of amoxicillin may be needed (concomitant use of amoxicillin and (Augmentin). First-generation cephalosporins are effective but may prove unsuccessful in patients with large inocula. Pediazole is clinically effective although penetration of erythromycin in the ear is delayed. The new oral third generation cephalosporins are effective in infections due to beta-lactamase-producing Haemophilus strains. A bacteriologic study should be performed routinely whenever otitis media occurs in an infant under three months of age.
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PMID:[Antibiotic treatment of acute otitis media]. 174 53

Specific IgG and IgA antibodies against the outer membrane proteins of non-typable Hemophilus influenzae were investigated in otitis media with effusion in children. Amounts of these antibodies were determined in middle ear effusions (MEEs) and in sera by enzyme-linked immunosorbent assay. At the same time the amounts of total IgG and IgA antibodies in MEEs in comparison with those in sera were analyzed by laser nephelometry. The amounts of specific and total IgG and IgA in the MEEs were higher than those in the sera. The MEEs/sera ratios of IgG and IgA antibodies in the children with mucoid effusions were higher than those in the children with serous effusions. The exception involved IgG determined by laser nephelometry. These data support the hypothesis that bacterial infections and the subsequent immune response contribute to the prolongation of otitis media with effusion in children, especially when effusions become mucoid.
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PMID:The immunological role of the outer membrane proteins of non-typable Hemophilus influenzae in otitis media with effusion in children. 176 12

The major pathogens causing acute otitis media (AOM) are Streptococcus pneumoniae and Haemophilus influenzae, with Moraxella catarrhalis, Streptococcus pyogenes, and Staphylococcus aureus less frequently isolated. The same organisms and Staphylococcus epidermidis are found in chronic otitis media with effusion. In chronic suppurative otitis media, Pseudomonas aeruginosa and S aureus are most frequently found. Antimicrobial agents found to be most effective in treating AOM are amoxicillin, trimethoprimsulfamethoxazole, erythromycin-sulfisoxazole, amoxicillin-clavulanate, and cefaclor. Cefuroxime axetil and cefixime are alternatives for which there are less data. Currently, about 20% of AOM cases are caused by beta-lactamase-producing strains (usually H influenzae or M catarrhalis) that are resistant to amoxicillin, thus favoring the use of the other agents listed. Concentrations of antibiotics in middle ear infections range from 10% to 76% of peak serum levels for the listed agents and are higher in AOM than in chronic otitis media with effusion, emphasizing the importance of adequate dosing for successful treatment.
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PMID:Antimicrobial treatment of otitis media. 177 7

The clinical manifestations of acute otitis media and otitis media with effusion are the result of abnormal eustachian tube function most often caused by inflammation from infection or allergy. The majority of cases involve bacterial infection of the middle ear caused by Streptococcus pneumoniae, Haemophilus influenzae, or Branhamella catarrhalis. Nearly half of all children will have had at least one episode of acute otitis media by 1 year of age, and over 70% by 3 years of age. The signs and symptoms include pain with rubbing or tugging at the ear, fever, irritability, lethargy, and hearing loss. The primary therapy for acute otitis media and otitis media with effusion is antibiotics with the goal of preventing possible complications and providing symptomatic relief. Amoxicillin remains the initial drug of choice in communities where beta-lactamase-producing strains of the common middle ear pathogens are infrequently isolated. If resistant organisms are prevalent, cefaclor, amoxicillin-clavulanate, or cotrimoxazole should be selected. Adjuvant agents such as decongestants have not been shown to provide additional therapeutic benefit. Children who develop chronic otitis media may require prophylactic antibiotic therapy and insertion of typanostomy tubes.
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PMID:Pharmacotherapy of otitis media. 186 12

This article reviews the immunologic reactivity in the middle ear in both the human disease and in animal models of otitis media. It differentiates the role of immune complexes in otitis media in the animal model and in the human form of middle ear inflammation. The effect of immunization of the gut on the mucosal immune system in the middle ear is briefly explored, and the source of lymphocytes that make their way into the middle ear mucosa from other parts of the mucosal immune system and systemic immune system are briefly discussed. Finally, work from the author's laboratory on the immune response of children with recurrent otitis media due to nontypable Haemophilus influenzae is summarized.
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PMID:Immunologic reactivity in the middle ear in otitis media with effusion. 187 Aug 78

SIgA- and IgG-coated bacteria obtained from 17 discharging middle ears (14 patients, 9 male, 5 female, age range from 1 to 79 years) were evaluated using an immunofluorescence assay. Simultaneously, quantitative and qualitative bacteriological analyses of the middle ear effusions (MEEs) were performed. MEEs containing Staphylococcus aureus harboured bacteria which were intensely coated with both SIgA and IgG antibodies. In contrast, MEEs containing Pseudomonas aeruginosa displayed minimal, if any, SIgA- and IgG-coated bacteria. Two young patients harboured bacteria (Haemophilus influenzae and S. aureus/Streptococcus pneumoniae, respectively) which were heavily coated with IgG, but not with SIgA. Immunoglobulin-coating of bacteria involved in otitis media is of the utmost importance in eradication of the infection.
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PMID:Secretory IgA- and IgG-coated bacteria in chronically discharging ears. 187 30

We compared the in-vitro activities of cefprozil, a novel oral cephalosporin, and of loracarbef, a new oral carbacephem, with other agents against middle ear fluid isolates obtained from children with acute otitis media. These included Streptococcus pneumoniae, Haemophilus influenzae and Branhamella catarrhalis. Cefprozil activity (MIC50 and MIC90) against S. pneumoniae was 0.25 and 0.50 mg/l; against H. influenzae 8 and 16 mg/l; against B. catarrhalis 2 and 2 mg/l. Loracarbef activity (MIC50 and MIC90) against S. pneumoniae was 1 and 2 mg/l; against H. influenzae 8 and 16 mg/l; against B. catarrhalis 1 and 8 mg/l. Cefprozil was four-fold more active against S. pneumoniae than loracarbef but similar to amoxycillin, amoxycillin/clavulanate, cefaclor, cefixime, cefuroxime and trimethoprim/sulfamethoxazole (TMP/SMX). Against H. influenzae, cefprozil was similar to loracarbef and other agents through less active than TMP/SMX and cefixime. Against B. catarrhalis, cefprozil was four-fold more active than loracarbef, cefaclor and cefixime but similar to the comparative antibiotics. Cefprozil and loracarbef activities were unaffected at pH 6 and 8 or in the presence of human serum, but there was a major diminution of activity for both agents at pH 5 and at inoculum sizes greater than or equal to 10(7) cfu/ml. Cefoprozil and loracarbef have consistent activity against middle ear pathogens and further pharmacokinetic and clinical studies appear warranted.
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PMID:In-vitro activity of cefprozil (BMY 28100) and loracarbef (LY 163892) against pathogens obtained from middle ear fluid. 190 88

Cefixime was compared with amoxicillin for treatment of acute otitis media in a randomized trial. Results of tympanocentesis on day 3 to 5 of therapy were used as the major outcome. Total daily doses were 8 mg/kg of cefixime and 40 mg/kg of amoxicillin. One hundred twenty-six patients were randomly assigned to receive treatment; 64 cultures grew pathogens. Pathogens were eradicated from the middle ear after 3 to 5 days of therapy in 27 (79.4%) of 34 children given amoxicillin and 26 (86.7%) of 30 children given cefixime (p = 0.47). When Streptococcus pneumoniae cases were analyzed, bacteriologic cure occurred in 14 (93.3%) of 15 children given amoxicillin and 12 (75%) of 16 given cefixime (p = 0.333). When cases of Haemophilus influenzae infection were analyzed, significantly more cures occurred with cefixime (10/10, 100%) than amoxicillin (8/13, 62%) (p = 0.046). Pathogens associated with failure of amoxicillin therapy were H. influenzae (five cases, two beta-lactamase-positive), S. pneumoniae (one case), and Moraxella catarrhalis (one case, beta-lactamase-positive). The four failures with cefixime therapy were all in patients infected with S. pneumoniae. Rates of rash, diarrhea, and vomiting were the same in both groups and did not necessitate stopping therapy. We conclude the following: (1) Cefixime and amoxicillin were equivalent in overall clinical and bacteriologic efficacy for otitis media. (2) Cefixime was more efficacious than amoxicillin in treating H. influenzae otitis media and should be preferred when H. influenzae is the suspected etiologic agent. (3) Side effects of both drugs were mild and equivalent.
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PMID:Cefixime compared with amoxicillin for treatment of acute otitis media. 190 97


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