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 present investigation was conducted to find out if a relapse of acute purulent otitis media is associated with a decreased sensitivity of nasopharyngeal pathogens to commonly used antimicrobial agents. All but one of 63 children with relapse included in this study yielded one or more of the classical middle ear pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, S. pyogenes) in their nasopharynx (NPH) secretions. S. pneumoniae was the predominating isolate from NPH (71% of the patients) as well as from middle ear effusion (53%). At a control visit 4 weeks after the start of antibiotic therapy, 91% were NPH carriers of potential pathogens and S. pneumoniae was still the most common isolate (53%). Beta-lactamase was produced by 55% of B. catarrhalis isolates from the NPH specimens on the first visit, but only by 33% of B. catarrhalis isolates on the control visit. Two NPH isolates of H. influenzae produced beta-lactamase. One isolate of S. pneumoniae (serotype 18) was intermediately sensitive to phenoxymethylpenicillin. Generally low MICs were found for erythromycin and cefaclor. H. influenzae isolates were generally sensitive to ampicillin in vitro, but only 1 isolate was fully sensitive to erythromycin. B. catarrhalis isolates were uniformly sensitive to doxycycline and trimethoprim/sulphamethoxazole. No tolerance to penicillin was demonstrated in S. pneumoniae and H. influenzae. The present data indicate that the relapse of acute otitis media is not associated with development of tolerance or resistance to therapeutic antimicrobials commonly used.
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PMID:Relapse of acute purulent otitis media: antibiotic sensitivities of nasopharyngeal pathogens. 361 95

One hundred children presenting with acute otitis media underwent a bacteriological study of otitis exudate over a 18 month period. The bacteria found were as follows: Streptococcus pneumoniae (24), Haemophilus influenzae (19), Staphylococcus aureus (12), Streptococcus pyogenes (7), Branhamella catarrhalis (3), and 18 Gram negative bacilli (including 7 Pseudomonas aeruginosa and 11 enterobacteriaceae). One pathogenic bacterium was isolated in 56 cases, 2 or more in 12 cases and none in 32 cases. In the age categories 0-1 year (47 cases) and 1-3 years (31 cases), S. pneumoniae and H. influenzae were the main organisms found, followed by S. pyogenes in children older than 3 years (22 cases). With respect to the antibiotics used for treating otitis, 5/22 S. pneumoniae and 4/17 H. influenzae were erythromycin resistant (9/17 had an intermediate susceptibility) and 7/19 H. influenzae and 1/17 S. pneumoniae were cotrimoxazole resistant. None of the S. pneumoniae and 2/19 H. influenzae were ampicillin resistant. These 2 H. influenzae and 2/3 B. catarrhalis were beta-lactamase producers. They were sensitive to the combination of amoxicillin with clavulanic acid.
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PMID:[Bacteriological study of acute otitis media in children. Therapeutic consequences]. 365 65

The ability of cefixime or amoxicillin to eradicate causative pathogens was evaluated in 140 infants and children with acute otitis media with effusion. When pretherapy and on-therapy bacteriologic cultures were used, success was defined as elimination of pathogens regardless of clinical improvement. Parent compliance with administration instructions was closely monitored. Cefixime was administered daily or twice daily and because results on the two dosage regimens did not differ, data were combined for analysis. Results suggested that cefixime was somewhat more effective than amoxicillin for acute otitis media with effusion caused by Haemophilus influenzae but less effective for infections caused by Streptococcus pneumoniae. The study agents were equally effective against Branhamella catarrhalis.
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PMID:Bacteriologic and clinical efficacy of cefixime compared with amoxicillin in acute otitis media. 369 39

The work was undertaken to investigate the spectrum of bacteria responsible for acute mastoiditis and to find out whether it is affected by intake of antibiotics prior to surgical treatment. The records were reviewed of 22 children with acute mastoiditis in whom mastoidectomy had been performed and bacterial cultures obtained. Eleven of the patients had had antibiotic treatment prior to admission (9 penicillin V and 2 erythromycin). Streptococcus pneumoniae was found in 8 of the purulent discharges: Haemophilus influenzae, Streptococcus beta-hemolyticus and Staphylococcus aureus in 2 each; Proteus mirabilis, Pseudomonas pyocyaneus and a Bacteroides strain in 1 each, while five discharges-all from patients pretreated with antibiotics-yielded no growth. None of the 9 patients pretreated with penicillin V provided pure cultures of pneumococci or beta-hemolytic streptococci, while one or the other of these species was found in 8 of the 11 untreated patients. Gram-negative bacteria were found both among those with and those without antibiotic pretreatment. The data indicate that pneumococci and beta-hemolytic streptococci are more likely to cause mastoiditis than are the other pathogens found in acute otitis media, and that, when drained at operation, purulent discharges are often found to have been sterilized by the pre-operative antibiotic treatment.
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PMID:Acute mastoiditis. Influence of antibiotic treatment on the bacterial spectrum. 373 92

Tympanocentesis was done on 36 patients (57 ears) with acute otitis media. Positive cultures were obtained in 65% of cases. Streptococcus pneumoniae was the most commonly isolated organism (25% of ears). There was a high incidence of Staphylococcus epidermidis infection (14% of ears); these organisms are considered to be true pathogens. Haemophilus influenzae seemed to be less common than in other series and in all our cases were non-producers of beta-lactamase. Penicillin and amoxycillin appeared to be equally effective and there seemed to be little difference between responses to cefaclor, erythromycin and co-trimoxazole.
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PMID:A microbiological study of acute otitis media in Bloemfontein. 379 84

The total concentration of secretory IgA (SIgA) and secretory component (SC) as well as the occurrence of pathogen specific serum type (IgG, IgA and IgM) and secretory type antibodies against Streptococcus pneumoniae and Haemophilus influenzae in the middle ear effusion during an attack of otitis media were studied by using the ELISA method. The middle ear effusion samples were taken at 2 to 4 weeks' intervals from patients with recurrent acute otitis media (RAOM) or secretory otitis media (SOM). In the samples of the RAOM patients the SC/SIgA ratio was 2.2, while in the SOM samples the ratio was 13.6. Both serum and secretory type antibodies to the infecting bacteria could be detected in the middle ear effusions in both of the patient groups. The results of this study show that the middle ear can develop antigenic specific antibodies against the infecting bacteria. The increased production of SC seems to be related to the pathogenesis of SOM.
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PMID:Secretory IgA, secretory component and pathogen specific antibodies in the middle ear effusion during an attack of acute and secretory otitis media. 383 1

Acute otitis media is commonly caused by pneumococcus and Hemophilus influenzae. Amoxicillin is recommended as the initial therapy when the causative agent has not been identified. If amoxicillin is ineffective, cefaclor is useful. Decongestants are of little proven value. Since most middle ear effusions resolve spontaneously in three to four months, surgical treatment is seldom indicated.
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PMID:Developments in diagnosing and treating otitis media. 387 49

Isolates were obtained from 169 middle ear aspirates of 148 children with recently treated acute otitis media (RTOM) and from 123 aspirates of 84 children with previously untreated acute otitis media (UOM). In RTOM Streptococcus pneumoniae and Group A streptococcus (P less than 0.02) were recovered less frequently whereas Staphylococcus aureus (P less than 0.001) and Haemophilus influenzae (P less than 0.02) were recovered more frequently than in UOM. Patients with RTOM had more beta-lactamase-producing organisms and multiple isolates. Bilateral sterile aspirates were more common in RTOM although bilateral otitis media was more common in UOM. In RTOM most Branhamella catarrhalis isolates were co-pathogens whereas Staphylococcus epidermidis were always isolated in pure culture. Amoxicillin was the antimicrobial most frequently (83.9%) received for the recently treated episode of otitis media. In RTOM 62.4% of isolates were susceptible to previously prescribed antibiotics, suggesting that factors other than antimicrobial susceptibility are also important in the occurrence of RTOM.
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PMID:Microbiology of recently treated acute otitis media compared with previously untreated acute otitis media. 387 1

A fixed combination of erythromycin ethylsuccinate and sulfisoxazole acetyl (erythromycin-sulfa) was compared with amoxicillin for the treatment of acute otitis media (AOM) in children. Of 145 patients studied, 76 boys and 69 girls were compliant and were evaluated for drug efficacy (72 amoxicillin, 73 erythromycin-sulfa). Based on otoscopic and tympanometric results, cure rates at ten to 14 days for AOM due to all organisms were 83% (63/72) for amoxicillin and 89% (65/73) for erythromycin-sulfa; for Haemophilus species (including mixed infections), they were 84% for amoxicillin (26/31) and 83% for erythromycin-sulfa (20/14). Cure rates for ampicillin-resistant Haemophilus were 1/1 for amoxicillin and 7/8 (88%) for erythromycin-sulfa; one patient (12%) had persistent AOM at day 10. Of the patients with AOM due to Streptococcus pneumoniae, 82% (29/35) in the amoxicillin-treated group and 98% (39/40) in the erythromycin-sulfa-treated group were cured. Patients with S pneumoniae as the initial infecting organism who were treated with amoxicillin had significantly more clinical recurrences then their erythromycin-sulfa-treated counterparts, 66% (8/12) vs 33% (3/9). There was no difference between treatment groups in recurrence rates for patients with Haemophilus as the initial infecting organism. On the treatment day indicated, the following number of patients had middle ear effusion: by days 10 to 14, 38% (27/72) amoxicillin-treated patients and 48% (35/73) erythromycin-sulfa-treated patients; by day 28, 10% (7/71) amoxicillin-treated patients and 16% (11/70) erythromycin-sulfa-treated patients. There were no significant differences in adverse reactions. The erythromycin-sulfa combination is safe and effective treatment for AOM, including ampicillin-resistant Haemophilus.
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PMID:Erythromycin-sulfisoxazole vs amoxicillin in the treatment of acute otitis media in children. A double-blind, multiple-dose comparative study. 389 89

The incidence of acute otitis media and its response to treatment only with nose drops and analgesics (but without antibiotics or myringotomy) were assessed over three months by 45 doctors in and around Tilburg. In addition, over 17 months 60 general practitioners assessed the effects of this limited treatment in children aged 2 to 12 years and referred all those in whom the condition took an unsatisfactory course (either a severe course--illness continuing beyond three to four days with high temperature or pain, or both--or persistent discharge after 14 days) to an ear, nose, and throat specialist. Those referred because of appreciable illness continuing beyond three or four days were entered into a further study, comparing the effects of myringotomy alone, antibiotics alone, and myringotomy and antibiotics combined. Bacteriology was assessed in all children in whom the course of the condition was unsatisfactory. More than 90% of an estimated 4860 children seen over 17 months (estimation based on incidence of severe course in the three month study) recovered within a few days. The course of the condition was severe in only 126 (2.7%) patients; haemolytic streptococci group A were identified in 30 of these 126 patients but Haemophilus influenzae in only one. One hundred of these patients with a severe course entered the trial of treatment, which showed antimicrobial treatment either alone or in combination to be more effective than myringotomy alone. Whether combined treatment was more effective than antibiotics alone remained unconfirmed. Acute otitis media in children can be treated with nose drops and analgesics alone for the first three to four days. Patients in whom this regimen is not accompanied by satisfactory recovery can be recognised within a short time and treated by the general practitioner.
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PMID:Acute otitis media: a new treatment strategy. 392 Oct 97


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