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

Otitis media, the diagnosis most frequently made by the pediatrician, is most effectively treated with antimicrobial therapy. Amoxicillin (or ampicillin) has been the standard for infants and children with acute otitis media because it is safe and effective for most of the causative bacterial pathogens. Amoxicillin has also been shown to be effective for treatment of some children with otitis media with effusion ("secretory" otitis media) and is the recommended prophylactic antimicrobial agent for prevention of frequently recurrent acute otitis media. However, during the past decade there has been an increasing rate of bacteria that are resistant to amoxicillin, primarily beta-lactamase-producing Haemophilus influenzae and Branhamella catarrhalis. Because of the emergence of these bacteria, other antimicrobial agents both old and new have been advocated for treatment and prevention of otitis media; amoxicillin-clavulanate and cefuroxime axetil are the newer agents. These agents are indicated for selected infants and children but for most patients amoxicillin remains a safe and relatively inexpensive effective "old friend".
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PMID:Management of otitis media in infants and children: current role of old and new antimicrobial agents. 306 37

Clinical and bacteriological studies were performed in 122 children, aged 1-10 years, with recurrent otitis media or failed therapy with phenoxymethyl penicillin. A specimen for bacteriological culture was taken from the nasopharynx in all patients, and in our material Haemophilus influenzae, Branhamella catarrhalis and Streptococcus pneumoniae were equally distributed, each forming one-third of the total bacterial count. Thus, H. influenzae and B. catarrhalis (as well as their betalactamase-producing strains) were found more frequently than is generally reported for acute otitis media. Treatment with amoxycillin/clavulanate (Spektramox) gave a high and satisfactory effect comparable to the treatment result of cefaclor (Kefolor). The eradication of the initial pathogens was achieved to a significantly higher extent with Spektramox than with Kefolor. Both drugs were well tolerated.
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PMID:Recurrent and penicillin V-resistant otitis media. A treatment study with amoxycillin/clavulanate and cefaclor. 314 May 74

Branhamella catarrhalis has been misconsidered as a normal resident in human respiratory tract for a long time. However, many authors recently have reported its pathogenecity and isolated it from the otolaryngological region. In our study, this organism can be isolated from the ear and nasal discharge in the child with acute otitis media by the rate of 7.5% and 21.4% respectively. Out of this 107 isolated strains, 97 strains (90.7%) were found to be beta-lactamase producing organisms. The MIC measurement of penicillins and cephems (except CEX) for inhibition of all these strains in our study is 6.25 micrograms/ml or less and because of the unreliability of the ABPC's susceptibility test by disk method, it is necessary to check the beta-lactamase production in each strain. Becoming of the high emergence rate of beta-lactamase producing strains, B. catarrhalis should be considered to be as important pathogen as Streptococcus pneumoniae and Haemophilus influenzae in upper respiratory tract infections in children.
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PMID:The antibiotic susceptibilities and beta-lactamase production of clinical isolated Branhamella catarrhalis from acute otitis media in children. 314 65

The authors report the results of the study of 435 bacteriological samples taken in children presenting with acute otitis media, in the out-patient department of ENT at the hospital Bretonneau (Paris) and in Valognes (Manche) from October 1981 to September 1987. Three bacterial organisms prevailed: Haemophilus (37 and 22% respectively), S. pneumoniae (25 and 7%) and Staphylococcus (16 and 17%). Pseudomonas was fairly frequent in cases with otorrhea, even when recent. Comparison with other studies shows the clear progression of the incidence of Haemophilus in acute otitis media. The percentage of the strains secreting a beta-lactamase was 17% whether the children live in the country or in town. The frequency of S. pneumoniae was independent of age but was clearly lower in cases with prolonged or relapsing otitis. According to these results, the authors discuss the therapeutic strategy for acute otitis media. Amoxicillin still remains the antibiotic of choice. In case of persisting or relapsing otitis, the bacteriological examination will allow choosing the best adapted antibiotic: first generation cephalosporin, clavulanic acid and amoxicillin or trimethoprime and sulfamethoxazole.
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PMID:[Bacteriologic study of acute otitis media in hospitals and private practice]. 320 71

A prevalence study was performed on the nasopharyngeal bacteriology of 112 young children, aged 4-6 years. During the preceding 2 years, 74 of these children had suffered from secretory otitis media (SOM) and 40 had had normal middle ear ventilation. At the examination, one-third of the children with SOM had improved their middle ear status (previous SOM group), whereas otomicroscopy and tympanometry remained unchanged in the healthy group. The nasopharyngeal swab sample was obtained from behind the soft palate by the oral route. The isolation rate of Streptococcus pneumoniae was significantly higher in the SOM group than in the two other groups of children (p less than 0.006). The most commonly isolated capsular types of pneumococci were 6, 19, and 23, corresponding to the types involved in acute otitis media. The isolation rate of Haemophilus influenzae was 50% and an even distribution was found among the three groups of children examined. Biotypes I, II, III and IV accounted for 75% of the isolated cases of H. influenzae. As in acute otitis media, S. pneumoniae also seemed to play an important role in the pathogenesis of tubal dysfunction and SOM, and the difference is probably caused by variations in the quantitative colonization of pneumococci in the nasopharynx.
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PMID:Nasopharyngeal bacteriology and secretory otitis media in young children. 325 98

In a double blind study 175 patients with acute otitis media were randomized into 2 treatment groups: 10 days of therapy with cefaclor or 5 days of therapy followed by 5 days of placebo. The dosage of cefaclor was 40 mg/kg/day administered orally in equally divided doses at 12-hour intervals. Tympanocentesis before treatment yielded specimens that contained Streptococcus pneumoniae or Haemophilus influenzae or both in 55% of specimens. Branhamella catarrhalis was isolated from 21% of specimens. Culture of material from the ear canal of patients with spontaneous perforation of the tympanic membrane of less than 24 hours duration yielded pneumococci or H. influenzae or both in 38% of specimens and staphylococci in 31%. Patients were scheduled for follow-up examinations at 5 or 6, 10, 30, 60 and 90 days. Of the 175 children 151 were evaluable at 10 days. There were 123 patients with both tympanic membranes intact at the time of diagnosis. There were 6 (10%) treatment failures of therapy in the 59 patients assigned to 5 days of therapy and 4 (6%) failures and 1 (2%) early relapse in the 64 assigned to 10 days of therapy (difference not significant). There were 28 evaluable patients with spontaneous perforation. There were 8 (53%) failures in the 15 children assigned to 5 days of therapy and only 1 (8%) failure in the 13 children assigned to receive 10 days of therapy (P = 0.016, Fisher exact test). Rates of reinfection and persistent middle ear effusion at 10, 30, 60 and 90 days follow-up were not significant different in patients assigned to 5 to 10 days of therapy. In patients with acute otitis media with intact tympanic membranes we have not been able to show any advantage of the standard duration of 10 days of therapy over a shortened course of 5 days. A 5-day course of antibiotic therapy does not appear to be sufficient for children with acute otitis media and spontaneous purulent drainage.
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PMID:Five vs. ten days of therapy for acute otitis media. 327 53

A prospective double blind trial compared the fixed combination of erythromycin-sulfisoxazole (E/S) with cefaclor in the treatment of acute otitis media. One hundred nineteen children in six centers across Canada were studied. Diagnostic tympanocentesis of 134 ears yielded 135 bacterial isolates: Streptococcus pneumoniae (42%); Haemophilus influenzae (21%); Branhamella catarrhalis (10%); Streptococcus pyogenes (5%); and other bacteria (22%). Seventy-seven percent of strains of B. catarrhalis and 14% of strains of H. influenzae were beta-lactamase producers. E/S exhibited greater in vitro activity against H. influenzae and B. catarrhalis. Twenty-three patients had bacteriologically sterile middle ear fluid. The overall clinical outcome at Days 10 and 31 was identical in both treatment groups. Otoscopic findings improved more rapidly in the E/S group than in the cefaclor group at 10 and 31 days (P less than or equal to 0.04). In cases where pre-treatment middle ear fluid was negative on routine bacterial culture, complete cure at 10 days was observed in 75% of patients treated with E/S but only in 14% of those treated with cefaclor (P = 0.02). Side effects were infrequent and comparable between the test drugs. E/S is at least as effective as cefaclor in the management of acute otitis media and may be superior, particularly for cases not yielding bacteria on routine culture.
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PMID:Comparative efficacies of erythromycin-sulfisoxazole and cefaclor in acute otitis media: a double blind randomized trial. 330 18

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


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