sultamicillin and Sinusitis

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 study the effectiveness of low dose sultamicillin in the treatment of acute sinusitis.. A total of 108 patients, between 16-56 years of age (mean 32.8), suffering from acute sinusitis took part in the trial. Patients received orally 2 x 375 mg sultamicillin, and compared with patients receiving 3 x 500 mg amoxicillin. The first control was made between the 5th and 7th days. A patient was considered clinically cured when all pretreatment signs and symptoms of infection were eliminated. Clinical improvement was defined as the partial disappearance of pretreatment signs and symptoms. In either result, study drugs were reconstituted for additional 5 days. Failure was defined as no change or worsening of signs and symptoms; and study drug was changed. The second control was made between 10-12th days, and the third was four weeks later.. The clinical success (improvement + cure) rate was (17+11)/42 (66.6%) and (28+21)/66 (74.2%) for amoxicillin and sultamicillin respectively, at first control. All improved patients were cured at the second control. No significant side-effects were noted in either amoxicillin or sultamicillin treated patients. All side effects were gastrointestinal, 11.9% and 3.0% in the same order.. Low dose sultamicillin was comparable to amoxicillin; sultamicillin has fewer side effects than amoxicillin (p>0.05).

Topics: Acute Disease; Adolescent; Adult; Amoxicillin; Ampicillin; Anti-Bacterial Agents; Female; Humans; Male; Middle Aged; Single-Blind Method; Sinusitis; Sulbactam

We carried out clinical and bacteriological studies on sultamicillin (SBTPC) in pediatric sinusitis at 10 general practice settings. The results are summarized as follows. 1. The major isolated organisms from purulent nasal discharges were Streptococcus pneumoniae 27.5%, Haemophilus influenzae 32.4% and Moraxella catarrhalis 9.9%. Similar results were observed for the major isolates from nasopharynx. 2. 33% of the isolated S. pneumoniae were penicillin-insensitive S. pneumoniae (PISP) against which the MICs were equal to or higher than 0.1 microgram/ml. 3. PISP was isolated from 14% of all cases. 4. The clinical efficacy rate was 77.5% and was deemed satisfactory. 5. In the bacteriological study, persistence rate of PISP was 38.5% among the PISP from purulent nasal discharge and 60.0% among the PISP from nasopharynx which and these values were significantly higher than persistence rates of PSSP, H. influenzae and M. catarrhalis. 6. Adverse reactions were observed in 21.5% of all cases, involving diarrhea and loose stool.

Topics: Ampicillin; Child; Child, Preschool; Dosage Forms; Drug Resistance, Microbial; Female; Haemophilus influenzae; Humans; Male; Sinusitis; Streptococcus pneumoniae; 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

Sinusitis is a common pediatric illness that can be complicated by periorbital or intracranial extension. Patients can be managed with antimicrobials alone or in conjunction with surgical intervention. This article examines management patterns and outcomes in pediatric patients presenting with complicated sinusitis.. Case series with chart review.. Tertiary care pediatric hospital.. An evaluation of 168 pediatric patients with complicated sinusitis with periorbital complications presenting at a single institution from 2008 to 2018 was performed. Demographics, disease characteristics, in-hospital management, and outcomes were recorded and analyzed.. The most common complication was orbital cellulitis, seen in 49% of children. Surgical intervention occurred in 49% of patients, with 36% receiving medical therapy followed by surgery (MTS). Chandler I patients underwent surgical intervention 30% of the time, Chandler II patients 29%, and Chandler III patients 83%. Nineteen percent of initially nonoperative patients started on ampicillin-sulbactam required MTS vs 57% of those started on other antibiotic regimens (. Nonoperative early stage patients started on ampicillin-sulbactam had a lower risk of MTS. MTS did not cost significantly more than SMT, and there were no significant outcome differences seen.

Topics: Administration, Intravenous; Ampicillin; Anti-Bacterial Agents; Child; Combined Modality Therapy; Female; Hospital Charges; Hospitals, Pediatric; Humans; Male; Ohio; Orbital Cellulitis; Sinusitis; Sulbactam; Treatment Outcome

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Anti-Bacterial Agents; Burkholderia cepacia complex; Burkholderia Infections; Cefazolin; Ceftibuten; Cephalosporins; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Nasal Polyps; Ofloxacin; Prospective Studies; Sinusitis; Sulbactam

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

Sultamicillin, an antibiotic combining ampicillin and the beta-lactamase inhibitor sulbactam, was administered to 13 patients diagnosed as having acute sinusitis. Specimens from sinus were obtained for all 13 patients by transantral puncture. Pharmacokinetics, bacteriology, and therapeutic efficacy were assessed. Eighty-five percent (11 of 13) were cured; two treatment failures were subsequently shown to have chronic (rather than acute) sinusitis during surgical exploration. Diarrhea was frequently encountered, and Clostridium difficile-associated enteritis was documented for one patient. Beta-lactamase-producing organisms were not encountered in this study; however, this study provides impetus for further controlled clinical trials.

Topics: Adult; Amoxicillin; Ampicillin; Bacterial Proteins; Bacterial Toxins; Cefaclor; Diarrhea; Drug Combinations; Humans; Maxillary Sinus; Microbial Sensitivity Tests; Penicillanic Acid; Sinusitis; Sulbactam