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)

Bacteriological, pharmacokinetic and clinical studies on cefdinir (CFDN, FK482), a new oral cephalosporin, 5% and 10% granules, were performed in the field of pediatrics. The results are summarized below. 1. Antibacterial activities Antibacterial activities of CFDN against Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, Escherichia coli and Klebsiella pneumoniae were studied in comparison with those of cefaclor (CCL), cefixime (CFIX) and amoxicillin (AMPC). MIC80's of CFDN against S. aureus, S. pneumoniae, S. pyogenes, H. influenzae, B. catarrhalis, K. pneumoniae and E. coli were 0.78, 0.20, less than or equal to 0.025, 0.39, 0.10, 0.20 and 0.10 micrograms/ml, respectively. These results show that CFDN has high antibacterial activities against these organisms. MIC80's of CFDN against Gram-positive bacteria were similar to those of AMPC, and was lower than those of CCL and CFIX. As for antibacterial activities against Gram-negative bacteria (GNB), the MIC80 of CFIX against H. influenzae was 0.05 micrograms/ml, which was slightly lower than that of CFDN. THe MIC80's of CFDN against other GNB were similar to those of CFIX. 2. Absorption and excretion Blood concentrations and urinary excretion rates of CFDN 5% and 10% granules and 100 mg capsule were determined. The data on CFDN 10% granules were similar to those on CFDN 5% granules. At a dose of 3 mg/kg, peak blood concentrations (Cmax's) of CFDN ranged from 0.20 to 2.12 micrograms/ml with 5% granules and from 0.50 to 1.15 micrograms/ml with 10% granules at 2 to 3 hours after dosing. At a dose of 6 mg/kg, peak concentrations were 0.66-2.06 micrograms/ml and 0.70-1.52 micrograms/ml with 5% granules and with 10% granules, respectively. At 8 hours after dosing, blood concentrations were 0.04-0.54 micrograms/ml at 3 mg/kg and 0.06-0.27 micrograms/ml at 6 mg/kg. Blood half-lives were 1.33-4.36 hours at 3 mg/kg and 1.14-3.27 hours at 6 mg/kg. AUC's were 1.7-11.0 micrograms.hr/ml with 3 mg/kg and 2.4-8.7 micrograms.hr/ml with 6 mg/kg. With administration of single 100 mg capsule, Cmax's, blood concentrations after 8 hours, T1/2's and AUC's were 0.79-1.88 micrograms/ml, 0.20 micrograms/ml, 1.54-2.72 hours, and 5.2 micrograms.hr/ml, respectively. Urinary recovery rates in the first 8 hours ranged from 6.85 to 39.2% with 3 mg/kg and 6.08-25.5% with 6 mg/kg.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Bacteriological, pharmacokinetic and clinical studies of 5% and 10% granules of cefdinir in the pediatric field]. 149 96

Cefdinir (CFDN), a newly developed oral cephalosporin in a 10% fine granular form, was administered to 8 children and concentrations of the drug in plasma and urine and urinary recovery rates of the drug were determined. The subjects were divided into 2 groups of 4 children each; one group received 3 mg/kg of CFDN at 1 hour before meal (in the fasting state), and the other, at 30 minutes after meal. To study clinical and bacteriological effects of this drug, a mean dose of 4.8 mg/kg t.i.d. was administered for 8 days on the average to 9 children with various infections; tonsillitis (3 cases), acute bronchitis (1), pneumonia (1), acute purulent otitis media (1), urinary tract infection (2), and impetigo (1). MICs were determined for 6 drugs including CFDN, cefaclor, cefixime (CFIX), methicillin, cloxacillin, amoxicillin (AMPC) against 4 strains freshly isolated from children receiving CFDN. An inoculum size of 10(6) cfu/ml was used in the MIC-determinations. Adverse reactions and abnormal laboratory findings attributable to this drug were also examined in these children. The results obtained are summarized as follows. 1. Mean plasma peak levels of CFDN were observed at 2 hours after administration in the before-meal group and 4 or 5 hours after administration in the after-meal group mean peak values of 0.88 and 0.50 micrograms/ml, respectively. Mean half-lives were 1.61 hours in the before-meal group and 2.54 hours in the after-meal group, and mean AUCs were 4.24 in the former and 3.59 micrograms.hr/ml in the latter. 2. Mean urinary peak concentrations of CFDN were observed during 2-4 hours after dosing in the before-meal group and during 6-8 hours in the after-meal group with values of 93.3 and 44.8 micrograms/ml, respectively, in cases for which plasma concentrations of drugs were determined. Mean urinary recovery rates during the first 8 hours after administration in the before- and after-meal groups were 16.6 and 13.4%, respectively. 3. Good clinical effects were obtained with an efficacy rate of 100% in 9 patients with 6 diseases due to bacterial infections. 4. Good bacteriological effects were also obtained against 2 strains of Streptococcus pyogenes, 2 strains of Escherichia coli and 1 strain of Haemophilus influenzae with an eradication rate of 100%. In 3 cases of these and another case (normal flora), strains present before the study were replaced by other strains.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Pharmacokinetics and clinical effects of cefdinir 10% fine granules in pediatrics]. 149 97

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

One hundred five infants and children with acute otitis media were randomized to therapy with loracarbef, an experimental carbacephem antibiotic, or amoxicillin-clavulanate (Augmentin), an approved drug for this disease. Ninety-two were evaluable (46 in each group). Middle ear fluid samples obtained for culture before therapy grew Haemophilus spp. in 30% of cases, pneumococci in 29% of cases, and Moraxella catarrhalis in 15% of cases. beta-Lactamase-producing bacteria were found in 37% of patients. Clinical failure occurred in four loracarbef-treated patients and one amoxicillin-clavulanate-treated patient (P = 0.361). Recurrence of acute otitis media was more common in the 2 to 3 weeks after loracarbef treatment (eight patients) than it was after amoxicillin-clavulanate therapy (three patients), but not significantly so (P = 0.197). Thus, combined failure and recurrence occurred in 12 loracarbef-treated patients and four amoxicillin-clavulanate-treated patients (P = 0.052). Gastrointestinal side effects occurred in 13 loracarbef-treated and 21 amoxicillin-clavulanate-treated patients (P = 0.13). Diaper rash was more common with amoxicillin-clavulanate (22 patients) than with loracarbef (10 patients; P = 0.016). Satisfactory results were achieved with both antibiotics, and adverse effects, although common, were minor.
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PMID:Comparative evaluation of loracarbef and amoxicillin-clavulanate for acute otitis media. 185 78

A comparison of oral amoxycillin (500 mg tds) with amoxycillin/clavulanic acid (Augmentin; 750 mg tds) for 7 to 10 days was completed in 76 patients with lower respiratory infection. In another 9 patients, intravenous Augmentin alone was administered (1.2 g 8 hourly) for 3 days followed by oral doses as above for 7 days. In 50 (59%) patients the underlying chronic lung disease was bronchiectasis. Clinical improvement (1 + or more) was seen in 66% with amoxycillin, 60% with oral Augmentin and 56% with IV Augmentin. For radiographic improvement the respective figures were 47, 53 and 44 per cent. Bacteriologically, elimination was seen in 8% with amoxycillin and 45% with Augmentin (P less than 0.01), while partial success was seen in 16 and 24 per cent respectively. While for gram positive organisms, both drugs were similar in efficacy, for gram negative strains the overall success was 27% with amoxycillin and 67% with Augmentin. The main organisms isolated were Str pneumoniae (12), Klebsiella (41), Pseudomonas (21), E coli (9), Haemophilus (7) and Staph aureus (6). For bacteriologic sensitivity and consequent success, Augmentin may be superior in respiratory infections.
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PMID:Comparative study of amoxycillin and amoxycillin/clavulanic acid in lower respiratory infections. 188 92

A total of 102 children with recurrent otitis media or therapeutic failure after treatment with phenoxymethyl penicillin were entered into a double-blind study with parallel groups, comparing treatment with amoxycillin/clavulanate suspension (Spektramox) for 7 days with amoxycillin suspension (Imacillin) for 10 days. Bacterial and clinical investigations were performed. A total of 91 patients were evaluated for efficacy at the first follow-up visit (10-12 days after start of treatment). Amoxycillin/clavulanate and amoxycillin showed equally high, satisfactory treatment results, i.e. more than a 90% response. Similarly, there was no statistically significant difference between the treatment groups at the second follow-up visit (about 30 days after start of treatment). Bacteriological cultures from the nasopharynx showed equal distribution of Haemophilus influenzae, Branhamella catarrhalis and Streptococcus pneumoniae between the study groups. Elimination of the initially occurring pathogens was equal in the two study groups with the exception of B. catarrhalis which was eliminated to a significantly higher extent with amoxycillin/clavulanate. Both drugs were well tolerated. In patients with recurrent otitis media or therapeutic failure, treatment with amoxycillin/clavulanate for 7 days results in high, satisfactory clinical effects and is comparable to treatment with amoxycillin for 10 days.
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PMID:Amoxycillin/clavulanate versus amoxycillin in recurrent otitis media and therapeutic failure in children. 190 86

Branhamella catarrhalis is a Neisseriae-like organism that is the newest member of the family of pneumonic pathogens. The organism is seasonal, encountered only during the respiratory disease season. The majority of patients with pneumonia (80% to 90%) have underlying chronic pulmonary disease, and their clinical illness may be difficult to distinguish from exacerbations of lung disease by other causes. B catarrhalis is the most common bacterial pathogen in this setting after Haemophilus influenzae and Streptococcus pneumoniae. The organism is easy to identify in the laboratory, with a quality gram stain of sputum being the key to recognition. Most patients show patchy non-cavitary infiltrates on chest roentgenograms. Because 75% of isolates produce beta lactamase, empiric therapy with penicillin or amoxicillin is likely to fail. Recommended drugs include erythromycin, trimethoprim/sulfamethoxazole, amoxicillin/clavulanic acid (Augmentin), or one of the newer broad spectrum cephalosporins.
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PMID:Pneumonia due to Moraxella (Branhamella) catarrhalis. 249 50

In a prospective study, 105 infants aged 3-12 months with acute otitis media were randomly assigned to one of three treatment groups: amoxycillin/clavulanate ('Augmentin') alone (36 patients), myringotomy plus placebo (35 patients), or augmentin plus myringotomy (34 patients). The last two groups were double-blinded. Bacterial pathogens, mainly Haemophilus influenzae (of which 20% were beta-lactamase producers) and Streptococcus pneumoniae, were isolated from 60% of the ear exudates and all isolates were sensitive to augmentin. Most of the infants improved clinically within 3-6 days irrespective of the treatment protocol. As judged by otoscopy, 60% of the patients receiving augmentin, with or without myringotomy, recovered completely compared with 23% of patients treated with myringotomy plus placebo. Treatment with augmentin was also more effective than myringotomy with regard to persistence of ear infection. In the myringotomy plus augmentin group closure of the incision and resolution of the discharge from the incision site was faster than in the myringotomy plus placebo group. The addition of myringotomy to augmentin did not seem to affect either the persistence of the infection after treatment or the residual middle ear effusion.
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PMID:Randomised study of myringotomy, amoxycillin/clavulanate, or both for acute otitis media in infants. 256 3

Lung secretions from patients with bronchiectasis have been studied before and during treatment with amoxycillin/clavulanate (Augmentin 750 mg tds). beta-Lactamase activity was usually present in the sputum sol phase and originated from organisms not usually considered to be the major pathogen. The presence of beta-lactamase was related to inactivation of amoxycillin in the lung secretions. Extensive bacteriological investigation of the sputum before therapy showed several organisms to be present in each sample. Six of eight patients showed a good clinical and biochemical response to therapy with amoxycillin/clavulanate. This, however, could not be predicted or explained by the results of bacterial investigation although Haemophilus influenzae was eradicated in three of these responders. beta-Lactamase activity did not change during treatment, and this investigation thus failed to produce indirect evidence of penetration of clavulanate into the secretions.
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PMID:Role of beta-lactamases in the response of pulmonary infections to amoxycillin/clavulanate. 260 21

In a multicenter study, Augmentin pediatric suspension was given to 1,227 young children (3 months - 3 years) with otitis media seen in private practice. Patterns of otitis included first episodes, recurrences, and forms that had failed to respond to previous antimicrobial therapy. The study medication was given as a first-line treatment, on the basis of epidemiologic data, in a daily dose of 40 mg/kg for 7 to 10 days. In the 3 months to 3 years age group, two micro-organisms are prevalent, ie. Haemophilus influenzae, which is the most common agent and may produce beta-lactamases (10 to 18% of strains), and Streptococcus pneumoniae. Among our patients, the otitis-conjunctivitis syndrome caused by Haemophilus influenzae was fairly frequent (8.7% of cases). Clinical effectiveness as evaluated between D8 and D11 was good or very good in 91.2% of cases. Tolerance was satisfactory in 83% of patients. Side effects were uncommon and consisted primarily in gastrointestinal symptoms. We point out the potentially deleterious effect of concurrent anti-inflammatory treatment. Acceptability of the suspension was judged satisfactory by the parents in 91.6% of cases. Augmentin proved well-suited to epidemiologic data, outstandingly effective, well tolerated, and easy to use because of its presentation as a pediatric suspension; it is therefore an appropriate first-line drug in the common indication addressed in our study.
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PMID:[Treatment of acute otitis media in infants using an amoxicillin-clavulanic acid formulation (in the form of an oral suspension for pediatric use)]. 264 39


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