sultamicillin and Otitis-Media

To discuss the clinical aspects and management of internal jugular vein thrombosis associated with acute otitis media.. Case reports and review of the literature.. University hospital, tertiary referral center.. The authors describe two cases of internal jugular vein thrombosis, without sigmoid sinus thrombosis, secondary to acute otomastoiditis.. Jugular vein thrombosis was diagnosed in both cases by observation of filling defects of the involved jugular bulb on contrast-enhanced computed tomography and confirmed by conventional magnetic resonance and magnetic resonance venography.. Both patients recovered after recanalization of the vessel concomitant to anticoagulation and antibiotic treatment associated with a simple mastoidectomy.. Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.

Topics: Acute Disease; Amoxicillin; Ampicillin; Anti-Bacterial Agents; Anticoagulants; Child; Child, Preschool; Heparin, Low-Molecular-Weight; Humans; Jugular Veins; Male; Mastoiditis; Otitis Media; Phlebography; Sulbactam; Thrombosis; Tomography, X-Ray Computed

The combination of sulbactam and ampicillin is a safe and effective therapy for acute otitis media and acute epiglottitis in infants and children. Despite the lack of similar studies proving efficacy for other infections of the upper airway and certain adjacent structures, such as sinusitis, tonsillitis and cellulitis/abscess of the head and neck, this drug combination should also have a therapeutic role in the future for these conditions.

Topics: Ampicillin; Bacterial Infections; Child; Child, Preschool; Drug Therapy, Combination; Epiglottitis; Female; Humans; Infant; Male; Otitis Media; Respiratory Tract Infections; Sinusitis; Sulbactam

To determine if an antibiotic reduces the incidence of complications associated with influenza-like illness during an influenza epidemic.. During the outbreak of influenza in Kobe in 1998, 85 patients suffering from an influenza-like illness were randomly assigned to two groups. Patients received placebo or sultamicillin orally for 4 days. The incidence of complications of influenza-like illness were compared and statistically assessed.. There was no difference in the duration of fever or the incidence of acute otitis media. However, the incidence of pneumonia was significantly lower in the sultamicillin group than the placebo group (2.4 vs 16.3%, P < 0.05).. Sultamicillin reduced the incidence of pneumonia associated with influenza-like illness during the influenza epidemic. This result suggests that antibiotics can reduce the rate of pneumonia associated with influenza.

Topics: Acute Disease; Ampicillin; Bacterial Infections; Child, Preschool; Diarrhea; Disease Outbreaks; Drug Therapy, Combination; Female; Fever; Humans; Incidence; Influenza A virus; Influenza, Human; Japan; Male; Otitis Media; Pneumonia, Bacterial; Population Surveillance; Sulbactam; Urban Health

Sultamicillin is a mutual prodrug of ampicillin and sulbactam that is chemically linked by a diester bond. This investigational agent has beta-lactamase-inhibiting activity by virtue of sulbactam, a novel beta-lactamase inhibitor. A double blind randomized study was conducted to evaluate the safety, efficacy and tolerance of sultamicillin for treatment of acute otitis media compared with amoxicillin-clavulanate. A total of 144 subjects were included (96 randomly assigned to the sultamicillin and 48 to the amoxicillin-clavulanate groups). No safety concerns for sultamicillin were identified during the study. The clinical efficacy in effusion clearance between the two groups was found not to be statistically different at 10 days (P = 0.23) and 30 days (P = 0.72). Similar rates of side effects, primarily gastrointestinal, were reported in both study groups. Sultamicillin may be an alternative for the treatment of acute otitis media when persistence and recurrence of disease become an issue.

Topics: Acute Disease; Amoxicillin; Ampicillin; beta-Lactamase Inhibitors; Child; Child, Preschool; Clavulanic Acid; Clavulanic Acids; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Infant; Male; Otitis Media; Sulbactam

In an open study, children (age range 6 months-12 years) with otitis media due to a bacterial infection were treated orally with 50 mg/kg sultamicillin (n = 30) in two equal doses each day for a mean of 10 days, or 40 mg/kg cefaclor (n = 30) in three equal doses each day for a mean of 11 days. Earache was rapidly improved by either treatment; none of the 27 evaluable sultamicillin-treated or the 29 evaluable cefaclor-treated patients had earache after 8-10 days. Other signs and symptoms (reddened eardrums, perforated eardrums, middle ear fluid, hearing loss) gradually improved during treatment. All the pathogens isolated from patients in the sultamicillin treatment group were eradicated, as were all but one of the pathogens isolated from patients in the cefaclor treatment group. In the sultamicillin treatment group 65.4% of patients were cured and 34.6% were improved, and in the cefaclor group 65.5% were cured and 31.0% improved, but there was one treatment failure. Study drug-related adverse events were experienced by 33.3% of sultamicillin- and 40.0% of cefaclor-treated patients, all but one (urticaria in a cefaclor-treated patient) were gastro-intestinal. The dose administered was reduced by approximately 50% in patients experiencing adverse effects. This did not lead to any reduction in efficacy and no patient was withdrawn due to adverse events.

Topics: Acute Disease; Administration, Oral; Ampicillin; Bacterial Infections; Cefaclor; Child; Child, Preschool; Drug Therapy, Combination; Female; Humans; Infant; Male; Otitis Media; Sulbactam

A total of 110 adults with acute ear, nose and throat infections were treated orally with 750 mg/day (n = 9) or 1500 mg/day (n = 46) sultamicillin, or 500 mg/day (n = 51) or 1000 mg/day (n = 4) cefuroxime axetil for a minimum of 5 days. Variations in dose and duration of treatment were due to severity of symptoms. After treatment with sultamicillin for 8.1 +/- 1.5 days or with cefuroxime axetil for 7.9 +/- 1.6 days, local pain, erythema, exudate, oedema and adenopathies were improved in both treatment groups and all sultamicillin-treated patients were apyretic. All sultamicillin-treated and all but three cefuroxime axetil-treated patients experienced cure or improvement; only one cefuroxime axetil-treated patient discontinued treatment due to treatment failure. Gastrointestinal adverse events occurred in both treatment groups (eight sultamicillin-treated patients and three cefuroxime axetil-treated patients); one patient receiving cefuroxime axetil discontinued treatment due to nausea. Pruritus was reported by one sultamicillin-treated patient.

Topics: Adult; Ampicillin; Bacterial Infections; Cefuroxime; Drug Therapy, Combination; Humans; Otitis Media; Pharyngitis; Respiratory Tract Diseases; Rhinitis; Sinusitis; Sulbactam; Tonsillitis

Topics: Abducens Nerve Diseases; Actinomycosis; Ampicillin; Anti-Bacterial Agents; Child, Preschool; Coinfection; Diagnosis, Differential; Fatigue; Fusobacterium Infections; Fusobacterium nucleatum; Gram-Positive Bacterial Infections; Humans; Male; Mastoiditis; Otitis Media; Peptostreptococcus; Pneumonia, Bacterial; Recurrence; Sulbactam; Syndrome; Trigeminal Neuralgia; Weight Loss

The pathophysiology and treatment of facial nerve paralysis associated with acute otitis media are still under debate. The objective of this study was to review treatment strategies and extent of recovery in adult patients with the aim of defining a standard treatment protocol for this rare pathologic condition.. Retrospective chart review.. University hospital, tertiary referral center.. Between 1993 and 2000, 11 patients were admitted for facial nerve paralysis secondary to acute otitis media. There were six women and five men without a history of chronic middle ear disease, who ranged in age from 21 to 71 years. Facial palsy was graded with the House-Brackmann scale: four patients had Grade III palsy, six had Grade IV palsy, and one patient had Grade V palsy. Bacteriologic examination of middle ear fluid was performed in four patients Streptococcus pneumoniae was observed in one patient, and the remaining three cultures were negative.. All patients were treated with parenteral ampicillin-sulbactam or a third-generation cephalosporin in conjunction with oral or intravenous corticosteroids, except in a single patient with diabetes mellitus who received antibiotics alone. Myringotomy alone or with ventilation tube application was performed in eight patients. A simple mastoidectomy without facial nerve decompression was used in a patient with sudden impairment to Grade VI paralysis and worsening otitis after an initial improvement.. Normal facial function returned in all patients, independently of the grade of the paralysis, the treatment strategy, or the outcome of the middle ear disease. The time of recovery varied from 2 weeks to 3 months, except for one patient who underwent mastoidectomy and in whom normal function returned in 10 months.. The treatment of facial nerve paralysis secondary to otitis media should be as conservative as possible, using antibiotics and corticosteroids. Myringotomy and a ventilation tube should be added when spontaneous perforation of the tympanic membrane is not present. Mastoidectomy should be performed only when it is necessary to treat otitis media. Facial nerve decompression should not be necessary.

Topics: Adrenal Cortex Hormones; Adult; Aged; Ampicillin; Cephalosporins; Combined Modality Therapy; Drug Therapy, Combination; Facial Paralysis; Female; Follow-Up Studies; Humans; Male; Mastoid; Middle Aged; Middle Ear Ventilation; Otitis Media; Pneumococcal Infections; Sulbactam; Tomography, X-Ray Computed

Topics: Acute Disease; Ampicillin; Child; Child, Preschool; Drug Therapy, Combination; Female; Humans; Infant; Male; Otitis Media; Sulbactam; Treatment Outcome

The importance of beta-lactamase-producing strains in acute otitis media and acute/chronic sinusitis, and the effectiveness of sulbactam/ampicillin were ascertained in vitro and in vivo. Of the strains isolated from 19 patients with otitis media, 40% are beta-lactamase producers whereas 44% of strains isolated from 22 patients with sinusitis produced beta-lactamase. When the most commonly isolated strains were treated with a range of antibiotics in vitro, they all showed 100% sensitivity to sulbactam/ampicillin. The clinical results for otitis media showed 63% recovery and 26% improvement, with only one (5%) failure (one patient did not complete treatment). For sinusitis the results were 55% recovery and 45% improvement, and no failures. For sinusitis, the end-of-treatment microbiological results showed complete eradication of the pathogens responsible for infection. The results indicate that sulbactam/ampicillin is an effective treatment for infections of the ear, nose and throat.

Topics: Adolescent; Adult; Ampicillin; Bacteria; Bacterial Infections; beta-Lactamases; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; In Vitro Techniques; Middle Aged; Otitis Media; Sinusitis; Sulbactam

The pharmacokinetics of sultamicillin and ampicillin suspensions were studied in 20 infants and children 8 months to 69 months of age (mean age, 27 months). Mean peak plasma concentrations of ampicillin and sulbactam occurred at 90 minutes after administration of 42.5 mg of sultamicillin (25 mg of ampicillin/kg and 17.5 mg of sulbactam/kg) per kg to fasting and non-fasting patients. Co-administration of milk usually resulted in higher concentrations of ampicillin and sulbactam, however, the differences in the AUC values between the fasting and fed groups were not statistically significant. Sultamicillin and ampicillin were administered in cross-over fashion to ten children. Plasma concentrations of ampicillin after 42.5 mg of sultamicillin per kg were greater at 20, 40, and 60 min than those after 25 mg of ampicillin per kg alone and the AUC was 39% larger in subjects who received sultamicillin than in those who received ampicillin. Plasma bactericidal activity against a non-beta-lactamase producing Haemophilus influenzae strain was similar for children who were given sultamicillin or ampicillin. Against a beta-lactamase-producing Haemophilus strain the median bactericidal titres were 1:8 at 40, 60 and 90 min after sultamicillin and less than 1:2 at the same intervals after ampicillin.

Topics: Ampicillin; Child, Preschool; Drug Combinations; Female; Humans; Infant; Male; Metabolic Clearance Rate; Otitis Media; Penicillanic Acid; Sulbactam