In Vivo Sensitivity Test in Otitis Media: Efficacy of Antibiotics

PEDIATRICS ◽  
1985 ◽  
Vol 75 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Virgil M. Howie ◽  
Ruth Dillard ◽  
Barbara Lawrence
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Penicillin G ◽  
Treatment Results ◽  
Double Blind ◽  
Phenoxymethyl Penicillin ◽  
Procaine Penicillin ◽  
The Poor

During a 10-year period, antibiotics were assigned in random, double-blind fashion in six combinations to treat 948 episodes of otitis media in children. Exudate from the middle ear of all patients was cultured before treatment. Three follow-up visits were conducted; the first follow-up visit was three to five days after the start of therapy, and the second and third visits were 14 and 31 days after onset of treatment. Exudates were recultured for 75% of the patients on the first follow-up visit. Comparison of treatment results showed that triple sulfonamide combined with either phenoxymethyl penicillin, or benzathine and procaine penicillin G given intramuscularly (IM) was as effective as was ampicillin or amoxicillin. Phenoxymethyl penicillin and cyclacillin alone were usually effective against pneumococci but relatively ineffective against Haemophilus influenzae. Cefaclor and trimethoprim-sulfamethoxazole produced unsatisfactory results in about half the cases caused by pneumococci or H influenzae. Although production of β-lactamase by some otitis-causing Haemophilus and Staphylococcus species may explain the ineffectiveness of some treatments, the percentage of organisms positive for β-lactamase was too small to be responsible for the poor results with certain drugs.

THE "IN VIVO SENSITIVITY TEST"—BACTERIOLOGY OF MIDDLE EAR EXUDATE

PEDIATRICS ◽  
1969 ◽  
Vol 44 (6) ◽  
pp. 940-944 ◽  
Author(s):  
Virgil M. Howie ◽  
John H. Ploussard
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Needle Aspiration ◽  
Sensitivity Test ◽  
Phenoxymethyl Penicillin ◽  
General Plan ◽  
Middle Ear Fluid ◽  
Time Period ◽  
Long Acting

During a 27-month study into the bacterial etiology of otitis media by needle aspiration and culture of the middle ear exudate, the efficacy of various antibiotics was evaluated. There were 858 episodes of otitis media studied with 1,233 aspirates and cultures performed, 271 of these during antimicrobial therapy-the "In Vivo Sensitivity Test." The antibiotics were prescribed to each patient on an individual basis with a general plan to alternate between two drugs during a given time period. When feasible, middle ear fluid was aspirated and cultured regardless of the patient's clinical response. Pneumococcus or H. influenzae was most effectively eliminated from middle ear exudate with ampicillin, phenoxymethyl penicillin with sulfonamides, and erythromycinsulfa. Long-acting sulfonamides, triple sulfonamide, and tetracycline are frequently ineffective against pneumococcus in middle ear exudate while benzathine penicillin, phenoxymethyl penicillin, and erythromycin are frequently ineffective against H. influenzae in middle ear exudate.

In vivo optical characterization of middle ear effusions associated with otitis media

2021 ◽  
Author(s):  
Jungeun Won ◽  
Guillermo L. Monroy ◽  
Ryan G. Porter ◽  
Michael A. Novak ◽  
Ronit Barkalifa ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Optical Characterization

scholarly journals Nontypeable Haemophilus influenzae Gene Expression Induced In Vivo in a Chinchilla Model of Otitis Media

2003 ◽  
Vol 71 (6) ◽  
pp. 3454-3462 ◽  
Author(s):  
Kevin M. Mason ◽  
Robert S. Munson ◽  
Lauren O. Bakaletz
Keyword(s):  
Gene Expression ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Middle Ear ◽  
Fluorescent Protein ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Bacterial Gene ◽  
Nthi Strain

ABSTRACT The gram-negative bacterium nontypeable Haemophilus influenzae (NTHI) is the predominant pathogen in chronic otitis media with effusion and, with Streptococcus pneumoniae and Moraxella catarrhalis, is a causative agent of acute otitis media. To identify potential virulence determinants, bacterial gene expression was monitored by differential fluorescence induction during early disease progression in one specific anatomical niche of a chinchilla model of NTHI-induced otitis media. Genomic DNA fragments from NTHI strain 86-028NP were cloned upstream of the promoterless gfpmut3 gene. NTHI strain 86-028NP served as the host for the promoter trap library. Pools of 2,000 transformants were inoculated into the left and right middle ear cavities of chinchillas. Middle ear effusions were recovered by epitympanic tap at 24 and 48 h, and clones containing promoter elements that were induced in vivo and producing green fluorescent protein were isolated by two-color fluorescence-activated cell sorting. Insert DNA was sequenced and compared to the complete genome sequence of H. influenzae strain Rd. In a screen of 16,000 clones, we have isolated 44 clones that contain unique gene fragments encoding biosynthetic enzymes, metabolic and regulatory proteins, and hypothetical proteins of unknown function. An additional eight clones contain gene fragments unique to our NTHI isolate. Using quantitative reverse transcription-PCR, we have confirmed that 26 clones demonstrated increased gene expression in vivo relative to expression in vitro. These data provide insight into the response of NTHI bacteria as they sense and respond to the middle ear microenvironment during early events of otitis media.

S224 – Efficacy of Long Silastic Sheet in COM Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P150-P150
Author(s):  
Hyong-Ho Cho ◽  
Hyun-Seok Choi ◽  
Chul-Ho Jang ◽  
Yong-Bum Cho
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Middle Ear Mucosa ◽  
Hearing Result ◽  
Staged Operation ◽  
Canal Wall Up

Objectives To determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery. Methods Between January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared. Results During the average follow-up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air-Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05). Conclusions Long silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first-stage operation.

Experimental Otitis Media Evaluated by Magnetic Resonance Imaging: An in Vivo Model

1992 ◽  
Vol 101 (3) ◽  
pp. 248-254 ◽  
Author(s):  
Kenny H. Chan ◽  
William J. Doyle ◽  
J. Douglas Swarts ◽  
David Kardatzke ◽  
Yoshie Hashida ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Agent ◽  
Otitis Media ◽  
Middle Ear ◽  
Washout Rate ◽  
In Vivo Model ◽  
Resonance Imaging ◽  
Middle Ear Mucosa

The use of magnetic resonance imaging in otitis media research is being explored in our laboratory. In this study, we present a new method for studying changes in the middle ear cleft due to an episode of induced otitis media in the chinchilla model. It uses gadolinium-diethylenetriamine pentaacetic acid, a magnetic resonance imaging contrast agent, to examine the uptake and washout characteristics of middle ear mucosa during an inflammatory episode. Parameters such as the time to maximum intensity of the mucosa and the washout rate of the contrast agent from the mucosa were significantly correlated to the duration of the infection.

Single-Dose Intramuscular Ceftriaxone for Acute Otitis Media in Children

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 23-30
Author(s):  
Steven M. Green ◽  
Steven G. Rothrock
Keyword(s):  
Single Dose ◽  
Confidence Interval ◽  
Otitis Media ◽  
Intramuscular Injection ◽  
Acute Otitis Media ◽  
Oral Suspension ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
Single Intramuscular Injection

This study evaluated the efficacy of a single dose of intramuscular ceftriaxone for acute otitis media in children, using amoxicillin as a control. (There is currently no established single-dose treatment for this condition.) In a prospective, randomized, double-blind, clinical trial, 233 children, aged 5 months to 5 years, with uncomplicated acute otitis media were randomly assigned to receive either a single intramuscular injection of ceftriaxone (50 mg/kg) plus placebo oral suspension for 10 days, or a placebo injection plus amoxicillin oral suspension (40 mg/kg per day divided three times per day) for 10 days in a double-blind fashion. Demographic and clinical characteristics were similar in both groups. Treatment was successful in 107 of 117 given amoxicillin (91%, 95% confidence interval 86% to 97%) and 105 of 116 given ceftriaxone (91%, 95% confidence interval 85% to 96%). Rates of improvement, failure, relapse, and reinfection were similar in both groups, as were the otoscopic and tympanometric evaluations at the 14- and 60-day follow-up visits. It is concluded that a single intramuscular injection of ceftriaxone (50 mg/kg) is as effective as 10 days of oral amoxicillin for the treatment of uncomplicated acute otitis media in children.

Otitis Media with Effusion: Results of Treatment with a Short Course of Oral Prednisone or Intranasal Beclomethasone Aerosol

1981 ◽  
Vol 89 (3) ◽  
pp. 386-391 ◽  
Author(s):  
Richard H. Schwartz
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Oral Prednisone ◽  
Pilot Project ◽  
Results Of Treatment ◽  
Short Course ◽  
Novel Method ◽  
Ear Effusion

A short course of prednisone suspension given in a decreasing dosage schedule for up to ten days was often effective (68%) in resolving mucoid otitis media with effusion (OME, middle ear effusion). No significant side effects were noted. Concommitant administration of sulfisoxazole suspension may have reduced the likelihood of activation of a quiescent infection of the middle ear. During an eight-month mean follow-up period, reaccumulation of the effusion was detected in 21% of the successfully treated children. Preliminary results of an unrelated, pilot project using intranasal beclomethasone dipropionate aerosol suggests that this novel method also may be efficacious in the treatment of OME.

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