[Children "healthy carriers" of pathogenic Escherichia coli in nurseries].
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Carrier State↗
Biomedical subjects
E Bingen
Publications and source records attributed to E Bingen.
Early synergistic killing activity at concentrations attainable in CSF of amoxicillin or cefotaxime and aminoglycosides against Haemophilus influenzae.
Rapid eradication of bacteria from the CSF is critical for the outcome of Haemophilus influenzae meningitis in children. In 15 patients studied, the mean H. influenzae colony counts in CSF were 10(5) CFU/ml (range: 10(2) to 10(9) CFU/ml). Time-kill curves were determined for amoxicillin and cefotaxime alone and in combination with gentamicin or amikacin, against 60 clinical isolates of H. influenzae at concentrations equivalent to those found in CSF following systemic administration. Against beta-lactamase-negative strains (n = 44) a bactericidal effect was observed at 18 h for amoxicillin alone, at 5 h for amoxicillin plus aminoglycosides and at 2.5 h for cefotaxime with or without aminoglycosides. Against beta-lactamase-positive strains a bactericidal effect was observed at 18 h for cefotaxime, at 5 h for amoxicillin plus aminoglycosides and at 2.5 h for cefotaxime plus aminoglycosides. It appears that despite low concentrations of gentamicin or amikacin in the CSF, the accelerated killing of H. influenzae provides a rationale for the initial use of the combination of cefotaxime and aminoglycosides in the initial treatment of H. influenzae meningitis.
Aminoglycosides↗
[Indirect pathogenicity: a cause of failure of various antibiotic treatments in pediatrics].
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Anti-Bacterial Agents↗
[Bacteriologic study of acute otitis media in hospitals and private practice].
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.
Acute Disease↗
[Value of inhibitory index in the comparison of 4 oral beta-lactams against germs responsible of bronchopulmonary infections in pediatrics].
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Amoxicillin↗
[Infections in pediatrics].
PROBABILITY-BASED ANTIBIOTIC THERAPY: In children, the risk of an unfavorable course of bacterial infections requires careful selection of the initial antibiotic prescription based on the disease state, bacterial epidemiology and the child's age. ACUTE COMMUNITY ACQUIRED PNEUMONIA: Before the age of 5 years, antibiotics active against Haemophilus influenzae such as amoxicillin or clavulanic acid can be given orally. In children over 5, amoxicillin or a macrolide are effective. SEVERE EAR, NOSE AND THROAT INFECTIONS: For sore throats, clinical and bacterial results of a 4-day antibiotic regimen using a second generation cephalosporin are equivalent (with better compliance) to a 10-day regimen of penicillin V. For acute middle ear infections, a combination of amoxicillin-clavulanic acid is usually prescribed as initial treatment. COMMUNITY ACQUIRED BACTERIAL MENINGITIS: The most recent consensus established the indication for cefotaxime or ceftriaxone. The increasing number of peni-R pneumococci and the major drop in the frequency of Haemophilus infections have led to new therapeutic propositions currently under investigation. ACUTE SKIN INFECTIONS: For impetigo, general antibiotics-oxacillin or a derivative-are required due to the risk of contagion. BONE AND JOINT INFECTIONS: For these urgent situations, in vitro sensitivity and antibiotic penetration into the infected tissue are the determining factors. BACTERIAL DIARRHEA: Antibiotics are not required in case of acute diaarhea with little or no fever. Antibiotics could be discussed for cholera-like diarrhea and are required in case of invasive bacterial diarrhea, shigelosis, cholera, and Clostridium difficile as well as diarrhea with fever and blood loss in infants or salmonella-induced diarrhea with signs of extradigestive complications. URINARY TRACT INFECTIONS: The choice of the antibiotic and the duration of treatment depend on the clinical presentation: lower tract infection, acute pyeloephritis, or prophylaxis. The causal germ must be identified for adapted antibiotic treatment.
Acute Disease↗