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Biomedical subjects

J E Hoppe

Publications and source records attributed to J E Hoppe.

At least 37 records · Page 2Linked to original sources
PubMed1996

In vitro susceptibilities of Bordetella pertussis and Bordetella parapertussis to four fluoroquinolones (levofloxacin, d-ofloxacin, ofloxacin, and ciprofloxacin), cefpirome, and meropenem.

The in vitro activities of levofloxacin, ofloxacin, d-ofloxacin, ciprofloxacin, cefpirome, and meropenem against 34 clinical isolates each of Bordetella pertussis and Bordetella parapertussis were determined by agar dilution on Mueller-Hinton agar supplemented with 5% horse blood. Levofloxacin was as active as ciprofloxacin against both species (MIC, 0.06 microgram/ml) and more active than ofloxacin and d-ofloxacin. Cefpirome was more active against B. pertussis (MIC, 1.0 microgram/ml) than against B. parapertussis (MIC, > 2 micrograms/ml), while the reverse was true for meropenem (MIC, 2.0 micrograms/ml against B. pertussis and 1.0 microgram/ml against B. parapertussis).

Anti-Infective Agents↗
PubMed1996

Rational prescribing of antibacterials in ambulatory children.

The rational prescribing of oral antimicrobial agents for bacterial infections in children who can be treated in an ambulatory setting is the subject of this review. First, restrictive use of antibacterials is advocated to avoid widespread development of bacterial resistance. The use of simple methods, suitable for office use, to discern viral from bacterial infections is recommended. Second, in selecting an antimicrobial agent, the physician should consider a number of distinctive features of each agent. Besides aspects of pharmacokinetics, antibacterial spectrum and tolerability, the number of daily doses and, of particular importance for children, the palatability of suspensions plays an important role in achieving patient compliance. Agents that can be administered once or twice daily and possess an agreeable taste in addition to proven efficacy, established tolerability and a reasonable price are to be preferred. Specific paediatric aspects in choosing among penicillins, cephalosporins, macrolides and other oral antibacterials are discussed. For pharmacoeconomic reasons, the optimal duration of antibacterial treatment and the role of short course therapy for various bacterial infections should be studied in more detail. Finally, rational antimicrobial treatment of common paediatric bacterial infections, such as streptococcal tonsillopharyngitis, acute otitis media, acute sinusitis, bacterial pneumonia, pertussis, Lyme borreliosis (early stage) and lower urinary tract infection is reviewed.

Ambulatory Care↗
PubMed1996

Rational prescribing of antibacterials in hospitalised children.

The subject of this review is the rational prescribing of antimicrobial agents for the therapy of serious community-acquired infections in hospitalised infants and children. First, cost-containment strategies such as streamlining of antibacterial therapy, outpatient parenteral antibacterial therapy and sequential ('stepdown') therapy with parenteral followed by oral therapy are reviewed. In most of these areas, paediatric studies are scant or lacking. Then specific paediatric aspects of the choice of parenteral antibacterials such as penicillins, cephalosporins, aminoglycosides, macrolides and other agents are discussed. With particular reference to cost containment, rational treatment strategies for some serious bacterial infections such as meningitis, occult bacteraemia, endocarditis, osteomyelitis, arthritis, pyelonephritis, Lyme borreliosis (advanced stages) and pneumonia are proposed. In most of these disease, there is potential for cutting treatment costs and studies that compare these newer strategies with traditional treatment regimens are urgently needed.

Anti-Infective Agents↗
PubMed1995

Comparison of media for agar dilution susceptibility testing of Bordetella pertussis and Bordetella parapertussis.

Antimicrobial susceptibility testing of the fastidious species Bordetella pertussis and Bordetella parapertussis is not standardized. In an attempt to find the optimal medium for agar dilution testing, the activity of erythromycin against Bordetella pertussis and Bordetella parapertussis (34 isolates each) was assessed using homologous broth/agar combinations of Bordet-Gengou, charcoal, Iso-Sensitest (Oxoid) and Mueller-Hinton media. Each medium was supplemented with 5% and 20% whole defibrinated horse blood. Mueller-Hinton medium supplemented with 5% horse blood performed best overall.

Agar↗
PubMed1995

Comparison of three methods for culturing throat swabs from cystic fibrosis patients.

In patients with cystic fibrosis who do not produce sputum, deep throat swabs are cultured for potential respiratory pathogens. Usually these swabs are directly streaked onto selective agar media. In a study of 50 pediatric cystic fibrosis patients, we compared this traditional method using rayon swabs with two methods having quantitative modifications: calcium alginate swabs eluted in Ringer's lactate and rayon swabs eluted in normal saline. The eluates were then processed quantitatively (three-step dilution series). The yield of potential pathogens was significantly higher with the two quantitative methods. Overall, the combination of alginate with Ringer's lactate was superior to the combination of rayon with saline, although only some of these differences achieved statistical significance.

Adolescent↗
PubMed1993

[Cryptosporidium enteritis].

Cryptosporidium has been found to be a common cause of gastroenteritis during the last years. The natural course of the disease in immunocompromised patients is often met by serious complications. A general therapy recommendation has not been reported so far. We report of a two-year-old boy, who was immunocompromised by a multidrug cytostatic chemotherapy. The patient suffered from a long lasting most severe gastroenteritis, caused by cryptosporidium. There was a good clinical response to spiramycin, a treatment suggested in the literature.

Antineoplastic Agents↗
PubMed1992

Comparison of erythromycin estolate and erythromycin ethylsuccinate for treatment of pertussis. The Erythromycin Study Group.

In an open randomized multicenter study 190 culture-positive pediatric ambulatory pertussis patients were treated for 14 days with either erythromycin estolate (EST) (n = 93; 40 mg/kg/day divided in 2 doses) or erythromycin ethylsuccinate (ETH) (n = 97; 60 mg/kg/day divided in 3 doses). On day 14 Bordetella pertussis was recovered from cultures of 2 patients (2.2%) treated with EST and 1 patient (1.0%) treated with ETH. Despite the fact that 151 patients (79.4%) had reached the early paroxysmal stage at initiation of antimicrobial therapy, clinical improvement was seen in the majority (reduced frequency and severity of coughing: EST, 77.4 and 67.7%; ETH, 74.2 and 63.9%, respectively). Drug-related side effects were noted in 11 patients (11.8%) treated with EST and 16 patients (16.5%) treated with ETH (P greater than 0.05) and consisted mainly of minor gastrointestinal complaints. Erythromycin estolate in a lower dose administered only twice a day was equivalent to erythromycin ethylsuccinate in all aspects and proved to be adequate antimicrobial treatment for pertussis patients.

Child↗
PubMed1992

Bacteriological and serological study of pertussis in Abeokuta, Nigeria.

Charcoal horse blood agar is the medium of choice for isolation of Bordetella pertussis from patients with early whooping cough. Since sterile animal blood often is not available in developing countries, a field study in Nigeria was undertaken to evaluate donated human blood as supplement to charcoal agar. Out of 209 children with suspected early pertussis, 33 were culture-positive (isolation rate 16%). Out of 188 children studied serologically by enzyme immunoassay, 36 (19%) were seropositive. The satisfactory isolation rate of 16% shows that culturing for B. pertussis on charcoal human blood agar can be tried in countries, where there is no regular supply of bacteriological media with animal blood.

Agar↗
PubMed1992

[Chemoprophylaxis in indirectly related cases of Haemophilus influenzae meningitis].

In January 1991, in a community near the South German town of Tübingen, an infant and a toddler developed a Haemophilus influenzae type B (HIB) meningitis within a period of one week. The patients had no direct contact with each other, but each of them had a healthy sibling that was older. These siblings attended the same kindergarten and the same group. Five months later we noted the same situation in another community. Two infants fell ill with HIB meningitis at short intervals from each other, and again both patients had no common contacts, but they did have healthy siblings attending the same kindergarten and group. Hence, it must be assumed that the HIB strain circulated among the healthy kindergarten children and was transmitted by these to the patients. In order to prevent that after the two pairs of patients we had observed, further patients would follow among the kindergarten children or their younger siblings, chemoprophylaxis with rifampicin was initiated in all kindergarten children, their younger siblings and the adult Kindergarten staff. The problems arising from these unusual case constellations in respect of mass prophylaxis with rifampicin in cases of Haemophilus influenzae type B meningitis that are merely indirectly linked to each other, are discussed.

Bacterial Capsules↗
PubMed1992

[Environmental chemoprevention of Haemophilus influenzae type B meningitis. Consequences of 2 indirectly related case pairs].

BACKGROUND: Within a few months we twice observed the following situation: In each of two different communities, a young child fell ill with meningitis caused by Haemophilus influenzae type B (HIB). One week later, a second case occurred in the same community. Both patients had had no direct contact with each other. But each had an asymptomatic older sibling. These siblings attended the same kindergarten and had close contact with each other. The isolated HIB strains were identical (capsular type b, biotype I, outer membrane protein subtype 1 and lipopolysaccharide serotype 1) and were beta-lactamase-negative. CONCLUSION: Since it must be assumed that the causative HIB strains circulated in the respective kindergartens and were transmitted to the patients by their healthy siblings, a rifampicin chemoprophylaxis was instituted which included all kindergarten children and their younger siblings. Since the current guidelines on chemoprophylaxis in HIB meningitis do not deal with a situation like the one encountered by us, a revision of the present guidelines was proposed and has been implemented in the meantime.

Carrier State↗
PubMed1990

In vitro susceptibilities of Bordetella pertussis and Bordetella parapertussis to seven fluoroquinolones.

The in vitro susceptibilities of Bordetella pertussis and Bordetella parapertussis to seven fluoroquinolones were assessed by the agar dilution method. Ciprofloxacin and temafloxacin were the most active compounds (MIC for 90% of isolates tested [MIC90], 0.06 microgram/ml), while enoxacin and pefloxacin were the least active (MIC90, 0.5 microgram/ml). Fleroxacin, lomefloxacin, and ofloxacin showed intermediate activities (MIC90s, 0.125 to 0.25 microgram/ml). These results suggest a possible role for the fluoroquinolones in the treatment of pertussis, at least in adult patients.

4-Quinolones↗
PubMed1990

In vitro susceptibilities of Bordetella pertussis and Bordetella parapertussis to six new oral cephalosporins.

Of six new oral cephalosporins, cefixime and cefpodoxime were the most active (MIC for 90% of isolates tested [MIC90], 16 micrograms/ml) against Bordetella pertussis, followed by cefetamet, cefprozil, and loracarbef (LY163892) (MIC90, 64 micrograms/ml) and ceftibuten (MIC90, 128 micrograms/ml). Against Bordetella parapertussis, loracarbef was more active (MIC90, 32 micrograms/ml) than the other compounds tested (MIC90s, 64 to greater than 128 micrograms/ml). The new oral cephalosporins are unlikely to play a role in pertussis treatment.

Bordetella↗