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)

We performed a randomized controlled trial of cefaclor administered twice daily compared with trimethoprim-sulfamethoxazole (TMP-SMZ) administered twice daily for the treatment of acute otitis media. Pathogens were eradicated from the middle ear exudate after 3 to 6 days of therapy in 35 of 37 (95%) patients given TMP-SMZ compared with 28 of 40 (70%) given cefaclor (P = 0.017). Haemophilus influenzae was eliminated in 13 of 14 (93%) patients given TMP-SMZ compared with 10 of 18 (56%) given cefaclor (P = 0.047). Clinical outcomes failed to distinguish between patients given TMP-SMZ or cefaclor. Symptoms improved despite persistent infection in 11 of 13 (85%) patients; middle-ear effusion persisted after therapy in 38 of 61 (62%) patients despite eradication of pathogens. We conclude that twice daily TMP-SMZ is more efficacious than twice daily cefaclor for the treatment of acute otitis media and that clinical outcomes may fail to detect differences between antibacterial agents in comparative drug trials in acute otitis media.
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PMID:A randomized controlled trial of cefaclor compared with trimethoprim-sulfamethoxazole for treatment of acute otitis media. 638 53

Seventy-eight patients, all over 10 years of age, with clinical signs of acute otitis media, received either phenoxymethyl penicillin or erythromycin stearate, in a randomized manner, and the clinical, bacteriological and immunological effects were studied. Haemophilus influenzae and Streptococcus pneumoniae were the major pathogens isolated from the nasopharynx in 30 and 28 patients, respectively. Increased levels of C-reactive protein (CRP) were detected in 53 (68%) of the patients. There was no statistical difference in the CRP-levels depending on species of bacteria isolated. The highest incidence was observed in cases with Branhamella catarrhalis and H. influenzae. Persistence of H. influenzae during antibiotic therapy was demonstrated in 70% and after therapy in 63% compared to 4% and 11% persistence of S. pneumoniae. The type of antibiotic treatment did not influence persistence. An immune response to H. influenzae and S. pneumoniae was detected significantly more often in patients treated with erythromycin stearate than with phenoxymethyl penicillin.
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PMID:Acute otitis media in older children and adults treated with phenoxymethyl penicillin or erythromycin stearate. Bacteriological and immunological aspects. 641 18

Questionnaires on antibiotic treatment of acute otitis media in children were sent to the general practitioners who make regular referrals to clinics in the King's College Hospital group. The most popular first choice of drug was amoxycillin (44%), but 37% of general practitioners said that they often used oral phenoxymethylpenicillin. This drug has relatively low activity against Haemophilus influenzae and many strains of Staphylococcus aureus. It is poorly absorbed from the stomach, does not penetrate the middle ear well, and its use may be one factor in the development of chronic middle ear effusions after acute otitis media. Sixty two per cent of the doctors who replied never treated acute otitis media with intramuscular antibiotics, but 57% used oral loading doses. Ninety seven per cent never treated their patients without antibiotics.
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PMID:Policies on antibiotics of south east London general practitioners for managing acute otitis media in children. 642 88

One hundred and ninety-three middle ear effusion samples from patients with acute otitis media were studied for cellular content and bacteria. Findings were compared with clinical and radiological data. In samples positive for pathogenic bacteria (Haemophilus, pneumococci) neutrophils predominated, whereas monocytes or phagocytes were more numerous in samples with nonpathogens. Inflammatory cells were more frequent in large than in small mastoid air cell systems. Destruction of cell walls was associated with increase of neutrophils and sclerosis with preponderance of lymphocytes, monocytes and phagocytes.
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PMID:Aspiration cytology in acute otitis media. 646 2

The management of acute otitis media is made more rational by consideration of the in vitro susceptibilities of the common pathogens, penetration of drug into middle ear fluid and results of comparative clinical efficacy trials. The emergence of beta-lactamase-producing Haemophilus strains and the finding that B. catarrhalis is a frequently encountered beta-lactamase-producing organism in some areas of the country emphasize the importance of delineating the cause of disease in children with acute otitis media. Because of the many variables that confound the response to therapy, each patient must be carefully followed and the regimen altered if the clinical response is unsatisfactory.
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PMID:Antimicrobial therapy for acute otitis media. 654 Aug 70

In this introductory presentation, the bacteriology of acute otitis media, sinusitis and orofacial infections is surveyed, and recent data on antibiotic resistance of the most common pathogenic bacteria are reported. In addition, the difference in the immunogenic effect of capsular polysaccharides from pneumococci and Haemophilus influenzae in children of different ages is mentioned. In acute otitis media and sinusitis, pneumococci and H. influenzae are the most common isolates followed in frequency by Branhamella catarrhalis and streptococci group A. It should be emphasized that the average relative risk of otitis media with effusion is much higher in children with viral respiratory infections than in children with nasopharyngeal colonization with pneumococci or H. influenzae. Anaerobic bacteria are the most common causes of odontogenic infections. Penicillin remains the most active of the currently available antibiotics against streptococci group A. Resistance to penicillin of clinical isolates has still not been documented, although resistance may occur to erythromycin and tetracycline. In pneumococci isolates obtained in Sweden, a relative resistance to penicillin occurs in a low percentage. They may also be resistant to erythromycin and tetracycline. The frequency of beta-lactamase producing H. influenzae has been followed nation-wide in Sweden during recent years. The mean frequency varies around 3-4% with local and seasonal peaks up to 12%. The majority of the H. influenzae isolates in Sweden are not fully sensitive to erythromycin, but resistance to chloramphenicol occurs. Most strains (including beta-lactamase producing) are sensitive to co-trimoxazole, cefuroxime, cefotaxime, cefotriaxone and cefaclor. Over 40% of clinical isolates of B. catarrhalis in Sweden produce beta-lactamase.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bacteriological aspects of infections of the upper respiratory tract. 658 Jul 37

In patients with acute otitis media who had failed to improve with ampicillin therapy, 35% of Haemophilus strains isolated from the middle ear were ampicillin-resistant. Twenty-nine children (24 of whom had failed to respond to ampicillin) were treated with 40 mg erythromycin ethylsuccinate per kg per day and 100 to 150 mg sulfisoxazole per kg per day. Middle ear exudate was cultured on chocolate and 5% sheep blood agar. Twenty-three of 29 Haemophilus isolates were nontypable, 10% (3 children) were type b, 2 were Haemophilus parainfluenzae and one was not typed. All strains were resistant to ampicillin by disc susceptibility testing, and 28 of 29 strains produced beta-lactamase. The minimal inhibitory concentration of ampicillin for 15 strains ranged from 3.12 to 100 micrograms/ml (median, 6.25 micrograms/ml). The erythromycin ethylsuccinate and acetyl sulfisoxazole combination was effective in treatment of acute otitis media secondary to ampicillin-resistant Haemophilus influenzae. After 10 days of erythromycin ethylsuccinate-sulfisoxazole therapy, 18 patients had normal tympanic membranes. Of 11 with middle ear effusion, 7 cleared, 3 had recurrent otitis media within 1 month and 1 had persistent otitis media with effusion. Our experience suggests the efficacy of this combination in otitis media caused by ampicillin-resistant H. influenzae.
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PMID:Erythromycin-sulfisoxazole for persistent acute otitis media due to ampicillin-resistant Haemophilus influenzae. 660 Dec 65

We performed a prospective study to monitor changes in the bacterial etiology of acute otitis media. Branhamella catarrhalis was isolated from middle ear exudates of 3 of 47 children (6.4%) studied between September 1979 and September 1980 and from 26 of 98 children (26.5%) studied between October 1980 and February 1982 (P = 0.0055). Twenty of 26 B. catarrhalis strains (76.9%) were found to be resistant to ampicillin and to produce beta-lactamase. In contrast only 2 of 26 strains of Haemophilus influenzae (7.7%) isolated from the same group of patients were resistant to ampicillin. We could not detect changes in culture methods, in demographic features, in patterns of medical care or in prior middle ear disease or antimicrobial drug usage, which might explain this striking increase in the relative importance of resistant strains of B. catarrhalis.
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PMID:Emergence of beta-lactamase-producing strains of Branhamella catarrhalis as important agents of acute otitis media. 660 Dec 66

Biotype and serotype were determined for 473 isolates of Haemophilus influenzae from 399 children. Patients with invasive disease usually had serotypable (86%) and biotype 1 (80%) isolates. Respiratory isolates from well children and children whose illness was not caused by H. influenzae were rarely serotypable (1%) or biotype 1 (8%). Respiratory isolates from children whose illness was possibly or probably related to H. influenzae and isolates from children with cystic fibrosis were more frequently biotype 1, serotypable, or both (P less than 0.01 for all comparisons). Ten (67%) of 15 children with acute otitis media due to H. influenzae had tympanocentesis isolates which were biotype 1; only one isolate was serotypable. Isolates from inflamed conjunctivae had biotypes and serotypes similar to respiratory isolates from well children. Ampicillin resistance was less frequent among biotype 1 isolates (9%) compared with other biotypes (19%) (P less than 0.01). The data suggest that H. influenzae is biochemically heterogeneous and that noncapsular factors, frequently predictable by biotype, contribute to virulence.
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PMID:Biotype of Haemophilus influenzae: correlation with virulence and ampicillin resistance. 660 83

A semiquantitative nasopharyngeal culture was found to be sensitive and specific in predicting middle ear pathogens in children with acute bacterial otitis media. In nasopharyngeal specimens with growth of at least 1,000 colonies, the tympanocentesis isolate was present and was either the predominant isolate or accounted for 50% of growth in 16 of 16 children. Data suggest that virulence of nasopharyngeal organisms plays a role in the pathogenesis of acute otitis media. Qualitative differences were found in the nasopharyngeal flora of children with bacterial otitis media as compared with children with clinical otitis media and sterile tympanocentesis cultures, children with uncomplicated upper respiratory illness, and healthy children. Abundant growth of Haemophilus influenzae (greater than or equal to 50% total colony count) was associated with children with bacterial otitis media, and abundant Branhamella catarrhalis was associated with the others (P less than or equal to 0.01). Abundant growth of Streptococcus pneumoniae occurred frequently and regardless of clinical category. Antibiotic treatment of children with otitis media resulted in rapid quantitative and qualitative changes in nasopharyngeal flora.
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PMID:Nasopharyngeal flora and acute otitis media. 660 29


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