ABSTRACT
OBJECTIVE: To determine whether prophylactic, short-term penicillin V treatment during upper respiratory tract infections can prevent the occurrence of recurrent acute otitis media in young children. METHODS: Seventy children were studied in a prospective, double-blind, placebo-controlled study. All children had suffered their first episode of acute otitis media before the age of 6 months. After inclusion in the study group, administration of penicillin V or placebo was initiated by the parents at subsequent upper respiratory tract infections. The children were examined by otomicroscopy within 3 days after treatment was initiated. The children were scheduled for a total follow-up period of 12 months, including bimonthly visits for check-up irrespective of treatment periods. RESULTS: There were 304 treated episodes of upper respiratory tract infection. There was no significant difference in the number of acute otitis episodes between groups. CONCLUSION: Initiation of penicillin V prophylaxis at upper respiratory tract infection in small children did not prevent recurrent acute otitis media in this study.
Subject(s)
Antibiotic Prophylaxis , Otitis Media with Effusion/etiology , Otitis Media with Effusion/prevention & control , Penicillin V/therapeutic use , Penicillins/therapeutic use , Respiratory Tract Infections/complications , Respiratory Tract Infections/drug therapy , Acute Disease , Child , Child, Preschool , Double-Blind Method , Humans , Prospective StudiesABSTRACT
In order to determine the aetiology of acute epiglottitis in adults, blood cultures, paired sera and a urine sample were obtained from 54 patients with fever and epiglottitis visualized by indirect laryngoscopy or by direct fibreoptic nasolaryngoscopy. Antibodies were determined against the capsular polysaccharide of Haemophilus influenzae type b (Hib), 3 pneumococcal antigens (a mixture of 23 capsular polysaccharides, C-polysaccharide and pneumolysin) and antistreptolysin O. Acute sera were examined by the polymerase chain reaction (PCR) for DNA of Hib and pneumococci. The urine samples were examined for Hib capsular antigen. Blood cultures were positive in 15 patients. In another 16, serology and/or PCR verified the aetiology. Hib was the cause in 14, pneumococci in 12 and group A streptococci in 5 patients. The aetiology remained unknown in 23/54 patients (43%). In conclusion, the addition of serology and PCR to blood cultures doubled the possibilities of verifying the aetiology of acute epiglottitis in adults.
Subject(s)
Epiglottitis/etiology , Haemophilus Infections/diagnosis , Pneumococcal Infections/diagnosis , Streptococcal Infections/diagnosis , Acute Disease , Adult , Aged , DNA, Bacterial/analysis , Epiglottitis/blood , Epiglottitis/microbiology , Female , Haemophilus Infections/complications , Haemophilus influenzae type b/isolation & purification , Humans , Male , Middle Aged , Pneumococcal Infections/complications , Polymerase Chain Reaction , Serologic Tests , Streptococcal Infections/complications , Streptococcus pneumoniae/isolation & purification , Streptococcus pyogenes/isolation & purificationABSTRACT
The question whether penicillin V (pcV) given intermittently upon signs of upper respiratory tract infections (URTI) in otitis-prone children might prevent recurrent bouts of acute purulent otitis media (AOM) is addressed. As compared with continuous long-term antibiotic treatment as prophylaxis in otitis-prone children, intermittent administration would reduce the overall consumption of antibiotics. Seventy-six otitis-prone children less than 18 months of age were included in this double-blind, randomized, placebo-controlled multicentre study. Follow-up was from January till June. One hundred and twenty-three episodes of AOM occurred. The number of AOM episodes was reduced by 50% in the children on pcV during URTI episodes as compared with those on placebo. No obvious ecological drawbacks were noted. Thus, the described mode of pcV administration seems to be a rational and safe way to reduce the number of AOM episodes in otitis-prone children.
Subject(s)
Otitis Media, Suppurative/prevention & control , Penicillin V/therapeutic use , Respiratory Tract Infections/drug therapy , Acute Disease , Amoxicillin/administration & dosage , Amoxicillin/therapeutic use , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Clavulanic Acid , Clavulanic Acids/administration & dosage , Clavulanic Acids/therapeutic use , Double-Blind Method , Female , Follow-Up Studies , Haemophilus influenzae/isolation & purification , Humans , Infant , Male , Moraxella catarrhalis/isolation & purification , Nasopharynx/microbiology , Penicillin V/administration & dosage , Placebos , Recurrence , Self Administration , Streptococcus pneumoniae/isolation & purificationABSTRACT
This study was performed in patients with allergic rhinitis/conjunctivitis to birch pollen to determine whether patients with additional hypersensitivity to nuts and apples differed from patients without such hypersensitivity; the determination was in terms of results of skin prick test (SPT), specific IgE antibodies (RAST), and symptoms during the pollen season. Forty-seven patients with birch pollen allergy were investigated by RAST against birch and hazel pollen and by SPT. They were treated in a randomized, double-blind, placebo-controlled study with fluticasone propionate aqueous nasal spray or placebo. The area of the SPTs was larger and the specific IgE values higher in patients with hypersensitivity to nuts and apples. These patients also had more symptoms during the pollen season. We conclude that hypersensitivity to nuts is an indication of a more severe allergy in patients with birch pollen allergic rhinitis.
Subject(s)
Food Hypersensitivity/complications , Fruit/adverse effects , Hypersensitivity/complications , Nuts/adverse effects , Pollen , Trees , Adolescent , Adult , Androstadienes/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Female , Fluticasone , Food Hypersensitivity/classification , Food Hypersensitivity/diagnosis , Food Hypersensitivity/epidemiology , Humans , Hypersensitivity/drug therapy , Immunoglobulin E/blood , Male , Middle Aged , Radioallergosorbent Test , Severity of Illness Index , Skin TestsABSTRACT
Thirty patients with allergic rhinoconjunctivitis were treated with eye drops containing 2% DSCG during the pollen season of 1977. Sixteen patients were treated with active substance and 14 with placebo. The results show a statistically significant difference in favour of the DSCG drops. DSCG in eye drops seems to be a valuable complement to the drugs available today for the treatment of allergic rhinoconjunctivitis.
