Pharmacology in ENT
Rogan J Corbridge in Essential ENT, 2011
The accessibility of the anatomical areas involved with disease often allows topical agents to be used more than is usual in most other specialties. A large number of different organisms are involved in infections of the ear. Streptococcus pneumoniae and Haemophilus influenzae are often the cause of otitis media and are implicated in infections of the external ear and otitis externa. Pseudomonas and Gram-negative rods are often found in otitis externa. There are many drug preparations used in the treatment of ENT disorders. Broad-spectrum penicillin such as amoxicillin, especially when combined with clavulanic acid, is often the drug of choice. Most topical drugs used in the nose aim to improve nasal airflow and often relieve rhinorrhoea. Long-term use of these drugs can cause rhinitis medicamentosa; therefore their application should be limited to short courses of 7–10 days. The mainstay of the treatment of rhinitis is topical steroid therapy.
Infections of the Respiratory Tract
Keith Struthers in Clinical Microbiology, 2017
With its direct access to the outside, and the various sources of organisms, it is not surprising that the list of organisms that can cause disease in the respiratory tract is vast. Included are pneumococcus, Streptococcus pyogenes , Mycoplasma pneumoniae , Chlamydophila pneumoniae and Mycobacterium tuberculosis . Important viruses to consider are influenza, metapneumovirus, parainfluenza, respiratory syncytial virus (RSV) and the ‘common cold’ rhinoviruses. In countries where vaccination programmes are in place, infection caused by Corynebacterium diphtheriae (diphtheria), Bordetella pertussis (whooping cough) and Haemophilus influenzae serogroup b (childhood epiglottitis) are uncommon.
Monobactams
Isao Kawamoto, Masao Miyauchi in Antibiotics I, 2020
A novel screening procedure led to isolation of the structurally unique, bacterially produced, monocyclic β-lactam antibiotics, typically, nocardicin A in 1976 and sulfazecin in 1981. The in vitro and in vivo antibacterial activities of carumonam were compared with those of aztreonam and ceftazidime Both carumonam and aztreonam were less potent than ceftazidime against Gram-positive bacteria. Carumonam was highly active against Gram-negative bacteria, including members of the Enterobacteriaceae family, Pseudomonas aeruginosa and Haemophilus influenzae . Carumonam was more stable to cephalosporinases, but was slightly less stable than ceftazidime to some penicillinases. Carumonam was not active against Staphylococcus aureus , like aztreonam, but carumonam was weakly active against Streptococcus pneumoniae . A. Imada et al. reported a synthetic sulfazecin derivative, carumonam. The excellent activity of carumonam against Gram-negative bacteria is related to its high affinity for their PBP-3. The PBPs of Staphylococcus aureus showed little affinity to carumonam.
Developing a vaccine to prevent otitis media caused by nontypeable Haemophilus influenzae
Published in Expert Review of Vaccines, 2016
M. Nadeem Khan, Dabin Ren, Ravinder Kaur, Saleem Basha, Robert Zagursky, Michael E. Pichichero
Nontypeable Haemophilus influenzae (NTHi) is a predominant organism of the upper respiratory nasopharyngeal microbiota. Its disease spectrum includes otitis media, sinusitis, non-bacteremic pneumonia and invasive infections. Protein-based vaccines to prevent NTHi infections are needed to alleviate these infections in children and vulnerable populations such as the elderly and those with chronic obstructive pulmonary disease (COPD). One NTHi protein is included in a pneumococcal conjugate vaccine and has been shown to provide efficacy. Our lab has been interested in understanding the immunogenicity of NTHi vaccine candidates P6, protein D and OMP26 for preventing acute otitis media in young children. We expect that continued investigation and progress in the development of an efficacious protein based vaccine against NTHi infections is achievable in the near future.
Meningitis caused by Neisseria Meningitidis, Hemophilus Influenzae Type B and Streptococcus Pneumoniae during 2005–2012 in Turkey
Published in Human Vaccines & Immunotherapeutics, 2014
Mehmet Ceyhan, Nezahat Gürler, Yasemin Ozsurekci, Melike Keser, Ahmet Emre Aycan, Venhar Gurbuz, Nuran Salman, Yildiz Camcioglu, Ener Cagri Dinleyici, Sengul Ozkan, Gulnar Sensoy, Nursen Belet, Emre Alhan, Mustafa Hacimustafaoglu, Solmaz Celebi, Hakan Uzun, Ahmet Faik Oner, Zafer Kurugol, Mehmet Ali Tas, Denizmen Aygun, Eda Karadag Oncel, Melda Celik, Olcay Yasa, Fatih Akin, Yavuz Coşkun
Successful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. Cerebrospinal fluid (CSF) samples were obtained prospectively from children from 1 month to ≤ 18 years of age hospitalized with suspected meningitis, in order to determine the etiology of meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Hemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total, 1452 CSF samples were evaluated and bacterial etiology was determined in 645 (44.4%) cases between 2005 and 2012; N. meningitidis was detected in 333 (51.6%), S. pneumoniae in 195 (30.2%), and Hib in 117 (18.1%) of the PCR positive samples. Of the 333 N. meningitidis positive samples 127 (38.1%) were identified as serogroup W-135, 87 (26.1%) serogroup B, 28 (8.4%) serogroup A and 3 (0.9%) serogroup Y; 88 (26.4%) were non-groupable. As vaccines against the most frequent bacterial isolates in this study are available and licensed, these results highlight the need for broad based protection against meningococcal disease in Turkey.
The history of pneumococcal conjugate vaccine development: dose selection
Published in Expert Review of Vaccines, 2013
Jan T Poolman, Carla CAM Peeters, Germie PJM van den Dobbelsteen
Pneumococcal conjugate vaccines (PCVs) differ in polysaccharide (PS) dose, carrier protein and conjugation method. PCV development proceeded initially upon principles successfully proven in Haemophilus influenzae type b (Hib) conjugate vaccine development. However, the need to successfully incorporate multiple serotypes while minimizing the total PS dose and total carrier protein load saw some early vaccine candidates fail. Dose–range studies of individual serotypes indicated that much lower PS doses were needed compared with Hib conjugate vaccines, although subsequent studies confirmed that lower Hib PS doses were possible. Furthermore, the immune response to individual serotype doses was carrier protein dependent. A ‘one-size fits most’ approach has characterized PS dose selection, but peculiarities of individual serotypes are increasingly apparent, raising the question whether re-formulation of PCVs to maximize individual serotype performance is needed.
Related Knowledge Centers
- Genome
- Influenza
- Pathogenesis
- Pasteurellaceae
- Viii
- Haemophilus
- Epiglottitis