Bacteriology of Acute Otitis Media in Adults

Celin, Scott E.; Bluestone, Charles D.; Stephenson, J.; Yilmaz, Hilary M.; Collins, Jeffrey J.

doi:10.1001/jama.1991.03470160081036

Cited by 39 publications

(9 citation statements)

References 13 publications

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“…Contrary to the belief that H. influenzae was an uncommon otogenic pathogen in adults who develop an episode of acute otitis media, this bacterium was commonly isolated from acute middle‐ear effusions following tympanocentesis/myringotomy. Currently, this influences selection of antimicrobial agents on an empirical basis for this age group when uncomplicated acute otitis media occurs 164 …”

Section: Microbiology Of Otitis Mediamentioning

confidence: 99%

Studies in Otitis Media: Children's Hospital Of Pittsburgh–University of Pittsburgh Progress Report—2004

2004

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Included in the discussion are the following: 1) studies of the epidemiology and risk factors; 2) anatomy and pathology of the eustachian tube-middle ear from human temporal bone histopathological specimens; 3) physiology and pathophysiology of the eustachian tube-middle ear in humans and animal models; 4) pathogenesis; 5) otitis media in special populations (e.g., patients with cleft palate, Native Americans, patients with Down syndrome); 6) microbiology; 7) diagnosis; 8) outcomes of randomized clinical trials that evaluated efficacy of nonsurgical and surgical methods of treatment and prevention; 9) studies of certain complications and sequelae (e.g., effect of middle-ear effusion on hearing, early child development, and the vestibular system; chronic suppurative otitis media). Also included are relevant summary tables and 256 references.

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Section: Microbiology Of Otitis Mediamentioning

confidence: 99%

Studies in Otitis Media: Children's Hospital Of Pittsburgh–University of Pittsburgh Progress Report—2004

2004

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“…Streptococcus pneumoniae is among the most common pathogens causing upper and lower respiratory tract infections (4,8,12). Although these bacteria have traditionally been susceptible to penicillin, the percentage of isolates that have either intermediate-level or high-level resistance has been increasing (2,3,10).…”

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confidence: 99%

Two Pharmacodynamic Models for Assessing the Efficacy of Amoxicillin-Clavulanate against Experimental Respiratory Tract Infections Caused by Strains of Streptococcus pneumoniae

Woodnutt

Berry

1999

Antimicrob Agents Chemother

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Two models of respiratory tract infection were used to investigate the pharmacodynamics of amoxicillin-clavulanate againstStreptococcus pneumoniae. Eight strains of S. pneumoniae were used in a mouse model in which the animals were infected intranasally and were then treated with a range of doses and dose intervals. The time that the plasma amoxicillin concentration remained above the MIC (T>MIC) correlated well with bacterial killing, such that if T>MIC was below 20% there was no effect on bacterial numbers in the lungs. As T>MIC increased, the response, in terms of decreased bacterial load, improved and at T>MICs of greater than 35 to 40% of the dosing interval, bacteriological cure was maximal. On the basis of equivalent T>MICs, these data would suggest that in humans a dosage of 500 mg three times daily (t.i.d.) should have efficacy equal to that of a dosage of 875 mg twice daily (b.i.d.). This hypothesis was evaluated in a rat model in which amoxicillin-clavulanate was given by computer-controlled intravenous infusion to achieve concentrations that approximate the concentrations achieved in the plasma of humans following oral administration of 500/125 mg t.i.d. or 875/125 mg b.i.d. Infusions continued for 3 days and bacterial numbers in the lungs 2 h after the cessation of the infusion were significantly reduced (P < 0.01) by both treatments in strains of S. pneumoniae for which amoxicillin MICs were below 2 μg/ml. When tested against a strain of S. pneumoniae for which the amoxicillin MIC was 4 μg/ml, the simulated 500/125-mg dose was ineffective but the 875/125-mg dose demonstrated a small but significant (P < 0.01) reduction in bacterial numbers. These data confirm the findings in the mouse and indicate that amoxicillin-clavulanate administered at 875/125 mg b.i.d. would be as effective clinically as amoxicillin-clavulanate administered at 500/125 mg t.i.d.

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“…Extending our recent work on bystander selection (Tedijanto et al, 2018), we used the 2015 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS) (National Center for Health Statistics, 2015a, 2015b), the Human Microbiome Project (HMP) (Huttenhower et al, 2012; The Human Microbiome Project Consortium, 2012), and assorted carriage and etiology studies (Bäckhed et al, 2015; Bluestone, Stephenson, & Martin, 1992; Bogaert et al, 2011; Brook, Thompson, & Frazier, 1994; Celin, Bluestone, Stephenson, Yilmaz, & Collins, 1991; Chira & Miller, 2010; Edlin, Shapiro, Hersh, & Copp, 2013; Ginsburg et al, 1985; Gunnarsson, Holm, & Söderström, 1997; Gupta et al, 1999; Jack M. Gwaltney, Scheld, Sande, & Sydnor, 1992; Hammitt et al, 2006; Holgerson, Öhman, Rönnlund, & Johansson, 2015; Susan S. Huang et al, 2009; Jain et al, 2015; Arch G. Mainous, Hueston, Everett, & Diaz, 2006; Pettigrew et al, 2012; Regev-Yochay et al, 2004; Verhaegh et al, 2010; Loretta Wubbel et al, 1999; Yassour et al, 2016) (details in Figure 1 – Source Data File 1) to estimate national outpatient antibiotic exposures by drug, species, and condition.…”

Section: Methodsmentioning

confidence: 99%

Potential impact of outpatient stewardship interventions on antibiotic exposures of bacterial pathogens

Tedijanto

Grad

Lipsitch

2019

Preprint

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The relationship between antibiotic stewardship and population levels of antibiotic resistance remains unclear. In order to better understand changes in selective pressure due to stewardship, we use publicly available data to estimate the effect of changes in prescribing on exposures to frequently used antibiotics experienced by potentially pathogenic bacteria that are asymptomatically colonizing the microbiome. We quantify this impact under four hypothetical stewardship strategies. In one scenario, we estimate that elimination of all unnecessary outpatient antibiotic use could avert 6 to 48% (IQR: 17 to 31%) of exposures across pairwise combinations of sixteen common antibiotics and nine bacterial pathogens. Across all scenarios, we find that successful stewardship interventions, facilitated by changes in clinician behavior and improved diagnostics, have the opportunity to substantially reduce exposures across a wide range of antibiotic-organism combinations. Concurrent approaches, such as vaccines aiming to reduce infection incidence, are needed to decrease exposures occurring in 'necessary' contexts.

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Bacteriology of Acute Otitis Media in Adults

Cited by 39 publications

References 13 publications

Studies in Otitis Media: Children's Hospital Of Pittsburgh–University of Pittsburgh Progress Report—2004

Studies in Otitis Media: Children's Hospital Of Pittsburgh–University of Pittsburgh Progress Report—2004

Two Pharmacodynamic Models for Assessing the Efficacy of Amoxicillin-Clavulanate against Experimental Respiratory Tract Infections Caused by Strains of Streptococcus pneumoniae

Potential impact of outpatient stewardship interventions on antibiotic exposures of bacterial pathogens

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