H. Influenzæ Meningitis: A Controlled Study of Treatment with Ampicillin

Thrupp, Lauri; Leedom, John M.; Ivler, Daniel; Wehrle, Paul F.; Mathies, Allen W.; Portnoy, Bernard

doi:10.1136/pgmj.40.suppl.119

Cited by 26 publications

(7 citation statements)

References 10 publications

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“…The observation by Ounsted (1950) quoted in the introduction to this paper was made in Oxford and confirmed by additional data from Oxford and Leeds and from Copenhagen (Ounsted, 1951 D. C. TU-RK in the first year of life, and 60-80 % within the first 2 years (see, for example, Koch & Carson, 1955;Thrupp et al 1964;, whereas epiglottitis is predominantly a disease of children between the ages of 2 and 4 years, and is uncommon in the first year of life (Jones & Camps, 1957;Baxter, 1967;Jones, 1970;Milko et al 1974). The patients with these two diseases in the present series conform to these age-patterns.…”

Section: Number Of Siblingssupporting

confidence: 61%

“…In this discussion the findings are first reviewed in the light of previous publications, and then some interpretations and an application of the findings are suggested. Sex ratio Many series of cases of haemophilus meningitis have shown a predominance of males among the patients, of about 3:2 or 5:4, as reported by Lindsay, Rice & Selinger (1940), Koch & Carson (1955), Shaw & Bruyn (1960) and Thrupp et al (1964), all from the U.S.A., and Turk & Wynter (1961) from Jamaica. Smaller sex differences were reported by Ouyang & Ting (1957) from Shanghai and by Barrett and his colleagues (1972) from Texas; and even a female predominance (36:43) by McGowan and his colleagues (1974) from Massachusetts.…”

Section: Discussionmentioning

confidence: 92%

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An investigation of the family background of acute haemophilus infections of children

Turk¹

1975

J. Hyg.

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SUMMARYNose and throat swabs, for culture of Haemophilus influenzae type b, and blood samples, for measurement of antibodies specific for that serotype, were collected from members of 28 families from which children had been admitted to hospital with acute H. influenzae type b infections (mainly meningitis or epiglottitis). The patients with meningitis were younger than those with epiglottitis and had more siblings, with a marked predominance of sisters. Investigations within a few days of admission of the affected children to hospital detected carriers of H. influenzae type b (19 altogether) in 13 of the 28 families, including 9 of the 13 families with 3 or more children. Members with raised antibody titres for H. influenzae type b (suggesting the presence of the organism for at least a few weeks) were found in 17 of the 25 families from which blood samples were obtained, including all 11 families with 3 or more children. Most of the patients probably acquired their infections from within their own families, and siblings under 11 years old were of predominant importance both as carriers and as potential sources of the patients' infections. Persistence of the organism within families for up to 6 months was demonstrated. Possible reasons for the difference in age-incidence between haemophilus meningitis and epiglottitis and for the occurrence of the former in babies with older sisters are suggested, and also a possible connexion between the results of this survey and the likely value of immunization against H. influenzae type b.

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Section: Number Of Siblingssupporting

confidence: 61%

Section: Discussionmentioning

confidence: 92%

An investigation of the family background of acute haemophilus infections of children

Turk¹

1975

J. Hyg.

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“…In recent years, ampicillin has been the drug of choice for treating meningitis due to H. influenzae (10,13,14); chloramphenicol and the tetracyclines have been acceptable alternates (6,13). Although treatment failures with ampicillin have been reported, the reasons for the failures could usually be attributed to factors other than resistance to ampicillin (2,8,14).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility of Haemophilus influenzae

Thornsberry

Kirven

1974

Antimicrob Agents Chemother

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Selected clinical isolates of Haemophilus influenzae were tested for their susceptibility to seven antibiotics by a microtiter broth dilution and an agar diffusion method. Eleven of 40 strains tested were resistant to ampicillin, the drug of choice, by both methods. All the strains tested were susceptible to chloramphenicol, and all but one were susceptible to tetracycline. Of the other four antibiotics tested, the ranges of minimal inhibitory concentrations (MICs) were: 0.5 to 4 pg of gentamicin per ml, 0.5 to 4 ,ug of erythromycin per ml, and 2 to 16 pg of clindamycin per ml. MICs of ampicillin for both the susceptible and resistant strains were markedly affected by inoculum concentration. The ampicillin MICs of the resistant strains were also affected by the time of incubation.

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“…Prior studies are older, have a small sample size and focus on efficacy rather than safety. (7–10) The many challenges of clinical trials in infants, including subject vulnerability, enrollment difficulties, and blood sampling limitations make it unlikely that a well-powered, dedicated, prospective safety study will be conducted. (6)…”

mentioning

confidence: 99%

Electronic Health Records and Pharmacokinetic Modeling to Assess the Relationship between Ampicillin Exposure and Seizure Risk in Neonates

Hornik

Benjamin

Smith

et al. 2016

The Journal of Pediatrics

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Objective To evaluate the relationship between ampicillin dosing, exposure, and seizures. Study design Retrospective observational cohort study of electronic health record (EHR) data combined with pharmacokinetic model derived drug exposure predictions. EHR from 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. All infants 24–41 weeks gestational age, 500–5400 g birth weight, first exposed to ampicillin prior to 25 days postnatal age. Using a 1-compartment pharmacokinetic model and her data, we simulated maximum ampicillin concentration at steady state (Cmaxss, µg/mL) and area under the concentration time curve from 0 to 24 hours (AUC24, µg*h/dL). Using multivariable logistic regression, we evaluated association between ampicillin dosing, exposure and seizures as documented in the EHR. Results We identified 131,723 infants receiving 134,041 courses of ampicillin for 653,506 infant-days of exposure. The median daily dose was 200 mg/kg/day (25th, 75th percentile; 100, 200). Median Cmaxss and AUC24 were 256.6 µg/mL (164.3, 291.5) and 2593 µg*h/dL (1917, 3334). On multivariable analysis, dosing was not associated with seizures. However increasing Cmaxss [Odds ratio (OR) = 1.10, (95% confidence interval (CI) 1.03, 1.17] and AUC24 [OR = 1.11, (95% CI 1.05, 1.18)] were associated with increased odds of seizures. Conclusions In this cohort of hospitalized infants, higher ampicillin exposure was associated with seizures as documented in the EHR.

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H. Influenzæ Meningitis: A Controlled Study of Treatment with Ampicillin

Cited by 26 publications

References 10 publications

An investigation of the family background of acute haemophilus infections of children

An investigation of the family background of acute haemophilus infections of children

Antimicrobial Susceptibility of Haemophilus influenzae

Electronic Health Records and Pharmacokinetic Modeling to Assess the Relationship between Ampicillin Exposure and Seizure Risk in Neonates

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