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)

Cefixime, a new third generation cephalosporin antibiotic for oral use, was evaluated for safety and efficacy in the treatment of children with acute otitis media with effusion. Fifteen United States clinical investigators participated in the multicenter clinical trial. One hundred twenty children were randomly assigned to a 10-day course of either cefixime, 8 mg/kg, given daily (qd) (60 patients) or amoxicillin, 40 mg/kg/day, administered in three divided doses (60 patients). Tympanocentesis was performed on each patient before therapy was initiated. Pathogens were isolated from a middle ear aspirate in 88% of the cases. Of the specimens from which pathogens were cultured, 33% yielded Haemophilus sp., 41% Streptococcus pneumoniae and 6% Branhamella catarrhalis. Of the 120 patients, 64 (30 cefixime and 34 amoxicillin) were evaluable for assessment of efficacy. Favorable clinical responses (cure or improvement) were obtained in 93% of cefixime-treated patients and in 94% of amoxicillin-treated patients. Overall, bacteriologic eradication rates (as determined by clinical criteria) were 94 and 95%, respectively. Clinical failure or relapse was documented in 2 of 30 (7%) patients treated with cefixime and in 2 of 34 (6%) patients treated with amoxicillin. Gastrointestinal disturbance and rash were significantly more common in children treated with cefixime (22 and 15%, respectively) than in those taking amoxicillin (8 and 2%, respectively), but in only one case was it necessary to discontinue medication because of these adverse effects (rash). Results of this study demonstrate that cefixime given once daily is as safe and effective as amoxicillin in the treatment of acute otitis media with effusion in children and has the possible advantage of less frequent dosing.
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PMID:Randomized, open label, multicenter trial of cefixime compared with amoxicillin for treatment of acute otitis media with effusion. 332 Sep 28

After ascertaining the bacterial spectrum in 210 patients with Otitis media acuta, Otitis media chronica mesotympanalis and Otitis media chronica epitympanalis, the clinical efficacy of oral therapy with ofloxacin in 40 patients from each of these groups was assessed. The clinical results are comparable with those following conventional local, oral and intravenous antibiotic therapy. The microbiological analysis of the ear secretions revealed Staphylococcus aureus, Streptococcus pyogenes and Haemophilus influenzae to be the main infectious agents of acute otitis media, whereas in chronic otitis media Pseudomonas aeruginosa and Proteus sp. could be detected in most of the cases. Ofloxacin levels of ear secretions, mucosa specimens of the middle ear and serum were measured in some patients by means of HPLC. In most cases, drug levels exceeded the MICs for the bacteria mentioned above. The correlation with the clinical results is discussed. On the basis of these preliminary results, ofloxacin can be considered as a highly efficient oral substance which is effective against S. aureus and P. aeruginosa, two important pathogens of middle ear infections.
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PMID:Ofloxacin in oral chemotherapy of acute and chronic otitis media. 346 67

This study evaluated the therapeutic role of ofloxacin in different forms of otitis media. After identifying the infecting bacteria in 250 patients with acute otitis media, or chronic otitis media, the clinical efficacy of orally administered ofloxacin 200mg twice daily was assessed in 45 patients from each of these groups. The clinical results were comparable with those obtained after conventional local and oral antibiotic therapy. Microbiological examination of the ear secretions revealed Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Haemophilus influenzae to be the main pathogens in acute otitis media, whereas in chronic otitis media P. aeruginosa and Proteus sp. were detected in most of the cases. Ofloxacin concentrations in secretions and mucosa specimens of the middle ear exceeded serum concentrations by more than 2-fold. On the basis of these preliminary results, ofloxacin appears to be an effective orally administered agent, without ototoxicity, which is effective against S. aureus and P. aeruginosa, 2 important pathogens in middle ear infections. Ofloxacin should be considered as an alternative for the therapy of otitis media, especially the chronic forms.
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PMID:Chemotherapy of otitis media with ofloxacin. 348 14

Eighty children with acute otitis media (AOM) were prospectively studied to determine the correlation and clinical usefulness of nasopharyngeal (NP), conjunctival (CONJ), and middle ear fluid (MEF) cultures. NP cultures correlated more accurately with MEF (p less than 0.01) than did CONJ cultures (p less than 0.05) for both Streptococcus pneumoniae and Haemophilus influenzae (H. flu). The positive predictive value of NP cultures for positive MEF was only 47%, but the negative predictive value was 87 percent. NP cultures, therefore, appear to have significant predictive clinical value only when negative in identifying children likely to have sterile MEF. High correlation of NP, CONJ, and MEF in children with H. flu conjunctivitis (p less than 0.01) suggests that early systemic rather than topical antibiotic treatment for H. flu conjunctivitis in small children may avert subsequent occurrence of the "conjunctivitis-otitis" syndrome.
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PMID:Correlation of nasopharyngeal and conjunctival cultures with middle ear fluid cultures in otitis media. A prospective study. 348 90

Seventy-eight patients with secretory otitis media were given erythromycin ethylsuccinate 50 mg/kg/day, divided into 2 doses, for 7-8 days before undergoing adenoidectomy and tympanostomy. Nasopharyngeal swabs for bacterial culture were obtained before medication and at surgery and the adenoid homogenate was also studied for bacteria. Pneumococci and Branhamella strains became significantly reduced, while Hemophilus influenzae showed no change. Pneumococcus and Branhamella strains partially returned one month after surgery and in part were found in patients who had not had these strains before antimicrobial therapy. Erythromycin ethylsuccinate can sterilize neither the adenoids nor the middle ear space if the causative agent is Hemophilus influenzae.
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PMID:Effect of erythromycin on adenoid bacteria. 348 44

Lipopolysaccharide endotoxin (LPS) was extracted from Haemophilus influenzae type b by using Westphal's phenol water method. The ears of 40 adult male guinea pigs were subsequently inoculated with 10 micrograms/ml solutions of LPS by transmeatal injections. Groups of animals were then sacrificed from day 2 to day 24 after the injections to observe the pathological changes produced. Massive serous effusions filled the tympanic bullae on days 2 and 4, after which the amount of fluid present gradually decreased so that it could hardly be seen on day 11. Pathological changes found in the mucosa included marked interstitial edema, dilated capillaries, as well as elevated and thickened epithelium with intracellular edema. These findings gradually subsided by day 24. We believe that the major pathogenetic factors present were due to the transudation and injury of the middle ear epithelium disturbing mucociliary transport activity, with increased secretions participating somewhat in inducing the effusion. We further suggest that H. influenzae endotoxin may play an active role in the clinical development of otitis media with effusion.
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PMID:Otitis media with effusion following inoculation of Haemophilus influenzae type b endotoxin. 348 52

Two immunochemical methods were used to identify Haemophilus influenzae and Streptococcus pneumoniae capsular antigens in the urine and serum of 162 children with acute lower respiratory tract infection. These methods were compared with standard bacterial blood culture. Viral and mycoplasma cultures of respiratory secretions were obtained simultaneously to determine the frequency of antigenuria at the time of nonbacterial acute lower respiratory tract infection. Urine from groups of well children and children with acute otitis media was tested for capsular antigens to determine the incidence of antigenuria. Antigenuria was found in 24% of children 2 months to 18 years of age with acute lower respiratory tract infection compared with a 2% incidence of bacteremia. Antigenuria was found in 4% of asymptomatic children and 16% of children with acute otitis media. One third of children with symptoms of acute lower respiratory tract infection and viral isolates from the oropharynx had bacterial antigenuria. The sixfold increase in frequency of bacterial antigenuria in children at the time of lower respiratory symptoms suggests that bacterial acute lower respiratory tract infection may be more common than identified by traditional culture techniques. Because bacterial antigen may come from other sites such as the middle ear, further studies are needed to determine the role of antigen detection in the diagnosis of pediatric acute lower respiratory tract infection.
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PMID:Use of bacterial antigen detection in the diagnosis of pediatric lower respiratory tract infections. 348 70

We studied 72 children (17 prospectively) with acute buccal cellulitis. The median age was 11 months. Fifty-five percent of patients were bacteremic, and three children without meningeal signs or symptoms had concomitant meningitis. Cellulitis aspirate cultures (eight of 35 positive) and urine bacterial antigen tests (13 of 27 positive) were useful in making an etiologic diagnosis. Infections due to other bacteria were clinically indistinguishable from those due to Haemophilus influenzae type b. The right cheek was affected more often than the left, and only 23 (32%) of 72 patients had otitis media ipsilateral to the involved cheek. The pathogenesis of buccal cellulitis likely involves direct mucous membrane invasion rather than spread from the ipsilateral middle ear.
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PMID:Buccal cellulitis reevaluated. 348 75

Because macrophage dysfunction has been suggested as one of the underlying pathogenic mechanisms for otitis media with effusion, we have examined macrophage-bacterial interactions using keyhole limpet hemocyanin-induced middle ear macrophages from chinchillas. Our data indicate that macrophages recruited to the middle ear were functional phagocytes capable of discriminate phagocytosis and intracellular killing of eight species of bacteria associated with otitis media, as determined by a fluorochrome microassay. Streptococcus pneumoniae types 14 and 19F, which are associated with the highest relapse frequency in cases of acute otitis media, were the most resistant to phagocytosis. The two organisms most often involved in chronic otitis media (Staphylococcus epidermidis and nontypable Haemophilus influenzae), however, were among the most readily phagocytized isolates. The relative importance of macrophage function in defense of the middle ear, therefore, may be dependent on the causative agent.
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PMID:Phagocytosis and killing of bacteria by middle ear macrophages. 349 13

The efficacy of a new third-generation cephalosporin, cefixime, in the treatment of acute otitis media resulting from infection with ampicillin-resistant, beta-lactamase-producing nontypable Haemophilus influenzae, was evaluated using the chinchilla animal model. The results showed that cefixime, administered in moderately low doses (8 mg/kg of body weight, two times per day), readily penetrated the chinchilla middle ear and rapidly sterilized the effusion. The data also suggest that the effusions were resolved more quickly in the cefixime-treated group compared with a group of animals treated with ampicillin or an untreated control group. No adverse side effects were noted in the cefixime-treated animals. The results of this study warrant the testing of cefixime for acute otitis media in the clinical setting.
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PMID:Efficacy of a new cephalosporin for acute otitis media. 349 18


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