Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
1.
Pediatr Infect Dis J ; 37(2): 132-134, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28763425

RESUMO

BACKGROUND: Streptococcus pneumoniae is the leading cause of acute otitis media (AOM). Ten-valent pneumococcal conjugated vaccine (PCV-10) was introduced to the Chilean National Immunization Program (NIP) in 2011. The aim of this study was to estimate the frequency of AOM in children <24 months of age attending the emergency department (ED) of Hospital Sótero del Río (HSR) 4 years before and 4 years after the introduction of PCV-10 in the Chilean NIP. METHODS: Register-based nested case-control study. Cases (n = 1907) were all children <24 months of age with a clinical diagnosis discharge of AOM at the ED of HSR, and controls (n = 244,334) were all other children <24 months of age attended at the same ED in the same time period, with any other discharge diagnosis. The data were obtained through HSR Statistical Service. RESULTS: In the study period, there was a mean of 30,695 children <24 months managed each year at the ED of HSR. The percentage with AOM in the prevaccine period was 0.94% and in the postvaccine period was 0.62%, respectively (P = 0.026). Exposure to the PCV-10 was associated with a decreased risk to develop AOM in children <24 months, with an odds ratio of 0.659 (95% confidence interval: 0.60-0.72). CONCLUSIONS: Our study showed a significant decrease in the percentage and risk of AOM in children <24 months of age who visited the ED of HSR after implementation of PCV-10 in the NIP in Chile.


Assuntos
Otite Média/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Streptococcus pneumoniae/imunologia , Doença Aguda , Estudos de Casos e Controles , Chile/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Programas de Imunização , Lactente , Masculino , Sistema de Registros
2.
Medicine (Baltimore) ; 96(6): e5974, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28178138

RESUMO

The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged <5 years in a public setting in Santiago, Chile.Children aged ≥3 months and <5 years referred to the physician for treatment of AOM episodes (with an onset of symptoms <72 h) were enrolled between September 2009 and September 2010. Middle ear fluid (MEF) was collected by tympanocentesis or by otorrhea for identification and serotyping of bacteria. Antibacterial susceptibility was tested using E-test (etrack: 112671).Of 160 children (mean age 27.10 ±â€Š15.83 months) with AOM episodes, 164 MEF samples (1 episode each from 156 children; 2 episodes each from 4 children) were collected. Nearly 30% of AOM episodes occurred in children aged 12 to 23 months. Streptococcus pneumoniae (41.7% [58/139]) and Haemophilus influenzae (40.3% [56/139]) were predominant among the cultures that showed bacterial growth (85% [139/164]). All Streptococcus pneumoniae positive episodes were serotyped, 19F (21%) and 14 (17%) were the predominant serotypes; all Haemophilus influenzae strains were nontypeable. Streptococcus pneumoniae were resistant to penicillin (5%) and erythromycin (33%); Haemophilus influenzae were resistant to ampicillin (14%) and cefuroxime and cefotaxime (2% each).AOM in Chilean children is predominantly caused by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. Use of a broad spectrum vaccine against these pathogens might aid the reduction of AOM in Chile.


Assuntos
Farmacorresistência Bacteriana , Haemophilus influenzae/classificação , Otite Média/microbiologia , Streptococcus pneumoniae/classificação , Pré-Escolar , Chile/epidemiologia , Feminino , Infecções por Haemophilus/epidemiologia , Humanos , Lactente , Masculino , Otite Média/epidemiologia , Infecções Pneumocócicas/epidemiologia , Estudos Prospectivos , Estações do Ano , Sorotipagem
3.
Pediatr Infect Dis J ; 36(3): 274-281, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27918383

RESUMO

BACKGROUND: Acute otitis media (AOM) is an important cause of childhood morbidity and antibiotic prescriptions. However, the relative importance of the well-known otopathogens, Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hflu), remains unclear because of a limited number of tympanocentesis-based studies that vary significantly in populations sampled, case definitions and heptavalent pneumococcal conjugate vaccine use. METHODS: We conducted a pooled analysis of results from 10 AOM etiology studies of similar design, the protocols of which were derived from a common protocol and conducted in children 3 months to 5 years of age in different countries. Generalized estimating equations were used to account for within-study correlations. RESULTS: The majority, 55.5% (95% confidence interval: 47.0%-65.7%) of 1124 AOM episodes, were bacterial pathogen positive: 29.1% (24.8%-34.1%) yielded Hflu and 23.6% (19.0%-29.2%) Spn. Proportions of Hflu and Spn were higher and lower, respectively, in heptavalent pneumococcal conjugate vaccine-vaccinated children. Hflu and Spn were each isolated from 20% to 35% of children in every 1-year age range. Hflu was less likely to be isolated from first (vs. subsequent) episodes [relative risk (RR): 0.71 (0.60-0.84)]. Spn was more often isolated from sporadic (vs. recurrent) cases [RR: 0.76 (0.61-0.97)]; the opposite was true for Hflu [RR: 1.4 (1.00-1.96)]. Spn cases were more likely to present with severe (vs. mild) symptoms [RR: 1.42 (1.01-2.01)] and Hflu cases with severe tympanic membrane inflammation [RR: 1.35 (1.06-1.71)]. CONCLUSIONS: Spn and Hflu remain the leading otopathogens in all populations examined. While associated with overlapping symptoms and severity, they exhibit some differences in their likelihood to cause disease in specific subpopulations.


Assuntos
Otite Média/microbiologia , Vacinação/estatística & dados numéricos , Doença Aguda/epidemiologia , Antibacterianos/farmacologia , Pré-Escolar , Estudos de Coortes , Feminino , Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/microbiologia , Haemophilus influenzae/efeitos dos fármacos , Haemophilus influenzae/isolamento & purificação , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Otite Média/epidemiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação
4.
Otolaryngol Head Neck Surg ; 138(1): 30-7, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18164990

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of once-daily (QD) fluticasone furoate (FF) nasal spray in children with perennial allergic rhinitis (PAR). STUDY DESIGN: A global, randomized, double-blind, placebo-controlled study. SUBJECTS AND METHODS: Pediatric patients (aged 2-11 years; n = 558) with PAR received once-daily placebo, FF 110 microg, or FF 55 microg for 12 weeks. Efficacy was evaluated by nasal symptom scores. General safety and corticosteroid-specific safety (nasal and ophthalmic examinations, and hypothalamic-pituitary-adrenal assessments) were assessed. RESULTS: No findings of clinical concern were identified from the safety assessments. For primary efficacy analysis of mean change from baseline over the first 4 weeks of treatment in daily reflective total nasal symptom score, FF 55 microg demonstrated significant improvement (P = 0.003) compared with placebo; however, the improvement for FF 110 microg versus placebo did not reach statistical significance (P = 0.073). CONCLUSION: FF QD was well tolerated and demonstrated efficacy in children aged 2 to 11 years with PAR.


Assuntos
Androstadienos/administração & dosagem , Antialérgicos/administração & dosagem , Rinite Alérgica Perene/tratamento farmacológico , Administração Oral , Androstadienos/farmacocinética , Antialérgicos/farmacocinética , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Fluticasona , Seguimentos , Humanos , Masculino , Rinite Alérgica Perene/sangue , Resultado do Tratamento
5.
Ann Otol Rhinol Laryngol ; 115(3): 186-90, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16572607

RESUMO

OBJECTIVES: We evaluated the in vitro antibacterial activity of amoxicillin against penicillin-susceptible and -nonsusceptible Streptococcus pneumoniae strains isolated from children with acute otitis media (AOM). METHODS: Children more than 3 months of age with AOM who were seen in the Dr Sótero del Rio and Luis Calvo Mackenna Hospitals in Santiago, Chile, between July 1998 and December 2002 were subjected to tympanic puncture for middle ear fluid culture. The penicillin and amoxicillin susceptibilities of the S pneumoniae isolates were determined by epsilometer test (E test). RESULTS: A bacterial pathogen was isolated in 432 of 543 children (80%) as follows: S pneumoniae, 40%; Haemophilus influenzae, 29%; Moraxella catarrhalis, 7%; and Streptococcus pyogenes, 4%. Penicillin-susceptible S pneumoniae strains were less common than amoxicillin-susceptible strains (60% versus 95%; odds ratio [OR], 0.08; 95% confidence interval [CI], 0.04 to 0.18). Both intermediate- and high-resistance strains were more common for penicillin (22% versus 4.5%; OR, 5.6; 95% CI, 2.5 to 12.7) than for amoxicillin (18% versus 0.5%; OR, 41.3; 95% CI, 6.0 to 821). CONCLUSIONS: Penicillin resistance is not extrapolable to amoxicillin among S pneumoniae strains isolated from middle ear fluid of children with AOM. Our results support the recommendation to evaluate the minimal inhibitory concentrations of penicillin-nonsusceptible S pneumoniae for amoxicillin and to continue use of this antimicrobial as a first-line antimicrobial choice for children with AOM.


Assuntos
Amoxicilina/uso terapêutico , Resistência a Ampicilina , Otite Média com Derrame/microbiologia , Resistência às Penicilinas , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/isolamento & purificação , Doença Aguda , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos/análise , Seguimentos , Humanos , Técnicas In Vitro , Lactente , Testes de Sensibilidade Microbiana , Otite Média com Derrame/tratamento farmacológico , Infecções Pneumocócicas/tratamento farmacológico , Estudos Retrospectivos , Streptococcus pneumoniae/efeitos dos fármacos
6.
Pediatr Infect Dis J ; 24(6): 525-32, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15933563

RESUMO

BACKGROUND: A large dosage pediatric formulation of amoxicillin/clavulanate with an improved pharmacokinetic/pharmacodynamic profile was developed to eradicate many penicillin-resistant strains of Streptococcus pneumoniae and Haemophilus influenzae (including beta-lactamase-producing strains). METHODS: This randomized, investigator-blinded, multicenter trial examined treatment of bacterial acute otitis media (AOM) in children 6-30 months of age with amoxicillin/clavulanate (90/6.4 mg/kg/d in 2 divided doses for 10 days) versus azithromycin (10 mg/kg for 1 day followed by 5 mg/kg/d for 4 days). Tympanocentesis was performed at entry for bacteriologic assessment, at the on-therapy visit (day 4-6) to determine bacterial eradication and at any time before the end-of-therapy visit (day 12-14) if the child was categorized as experiencing clinical failure. Clinical assessments were performed at the on-therapy, end-of-therapy and follow-up (day 21-25) visits. RESULTS: We enrolled 730 children; AOM pathogens were isolated at baseline for 249 of the amoxicillin/clavulanate group and 245 of the azithromycin group. For children with AOM pathogens at baseline, clinical success rates at the end-of-therapy visit were 90.5% for amoxicillin/clavulanate versus 80.9% for azithromycin (P < 0.01), and those at the on-therapy and follow-up visits were 94.9% versus 88.0% and 80.3% versus 71.1%, respectively (all P < 0.05). At the on-therapy visit, pretherapy pathogens were eradicated for 94.2% of children receiving amoxicillin/clavulanate versus 70.3% of those receiving azithromycin (P < 0.001). Amoxicillin/clavulanate eradicated 96.0% of S. pneumoniae (92.0% of fully penicillin-resistant S. pneumoniae) and 89.7% of H. influenzae (85.7% [6 of 7 cases] of beta-lactamase-positive H. influenzae). Corresponding rates for azithromycin were 80.4% (54.5%) for S. pneumoniae and 49.1% (100% [1 of 1 case]) for H. influenzae (all P < 0.01 for between-drug comparisons). CONCLUSION: Amoxicillin/clavulanate was clinically and bacteriologically more effective than azithromycin among children with bacterial AOM, including cases caused by penicillin-resistant S. pneumoniae and beta-lactamase-positive H. influenzae.


Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Otite Média/tratamento farmacológico , Doença Aguda , Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Azitromicina/administração & dosagem , Azitromicina/farmacologia , Pré-Escolar , Feminino , Haemophilus influenzae/efeitos dos fármacos , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Otite Média/microbiologia , Resistência às Penicilinas , Streptococcus pneumoniae/efeitos dos fármacos , Resultado do Tratamento
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 53(2): 67-70, ago. 1993. tab
Artigo em Espanhol | LILACS | ID: lil-131701

RESUMO

Con el objetivo de predecir la aparición de barotrauma se realizó un estudio prospectivo en 50 tripulantes de cabina de aviones comerciales en que se relacionaron los hallazgos de la prueba de función tubaria descrita por Honjo con la aparición de otalgia e hipoacusia durante el vuelo. Esta prueba resultó tener un sensibilidad de 100 por ciento , especificidad de 93,7 por ciento , valor predictivo positivo de 40 por ciento , y valor predictivo negativo de 100 por ciento . Estos resultados nos hacen concluir que la aplicación de la prueba de funcion tubaria de Honjo sería de gran utilidad como método diagnóstico predictivo de barotrauma


Assuntos
Humanos , Masculino , Adulto , Barotrauma/diagnóstico , Voo Espacial , Surdez/epidemiologia , Dor de Orelha/epidemiologia , Otopatias/diagnóstico , Testes de Função Vestibular
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA