Bacterial Sinusitis

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Ellen R. Wald - One of the best experts on this subject based on the ideXlab platform.

  • antibiotic recommendations for acute otitis media and acute Bacterial Sinusitis conundrum no more
    Pediatric Infectious Disease Journal, 2018
    Co-Authors: Ellen R. Wald, Gregory P. Demuri
    Abstract:

    There has been a substantial change in the prevalence and microbiologic characteristics of cases of acute otitis media secondary to the widespread use of pneumococcal conjugate vaccines. Current trends in nasopharyngeal colonization and the microbiology of acute otitis media support a change in the recommendation for antibiotic management of acute otitis media and acute Bacterial Sinusitis in children.

  • Microbiology of Acute, Subacute, and Chronic RhinoSinusitis in Children
    Diseases of the Sinuses, 2014
    Co-Authors: Gregory P. Demuri, Ellen R. Wald
    Abstract:

    Acute, subacute, and chronic rhinoSinusitis may involve an infectious etiology. Knowledge of the microbiology of Sinusitis is necessary because it impacts the choice of antibiotic therapy. The sinus aspirate is the most reliable source of microbiological data in Sinusitis in children. However, sinus aspirates are rarely done in cases of patients with rhinoSinusitis; the last time one was done in a child was in 1984. When they are done, sinus aspirate studies of children showed the presence of Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae, and Moraxella catarrhalis (M. catarrhalis). Unlike sinus aspirates, nasopharyngeal and middle meatal cultures are not reliable in determining the bacteriology of children with acute Sinusitis. The observation of an increase in the proportion of cases of acute otitis media caused by H. influenzae may reflect that in acute Sinusitis as well. Staphylococcus aureus does not play a significant role in uncomplicated acute Bacterial Sinusitis. The microbiology of acute otitis media can be used as a surrogate for that of acute Bacterial Sinusitis in children. In contrast to bacteria, the contribution of viruses to the pathogenesis of acute Bacterial Sinusitis has not been studied systematically. The pathogenesis of chronic Sinusitis may be related to Bacterial biofilms as a stimulant of chronic inflammation.

  • are nasopharyngeal cultures useful in diagnosis of acute Bacterial Sinusitis in children
    Clinical Pediatrics, 2013
    Co-Authors: Nader Shaikh, Alejandro Hoberman, Kathleen D Colborn, Diana H Kearney, Jong H Jeong, Marcia Kurslasky, Karen A Barbadora, Adelbert Bowen, Lynda L Flom, Ellen R. Wald
    Abstract:

    The diagnosis of acute Bacterial Sinusitis can be challenging because symptoms of acute Sinusitis and an upper respiratory tract infection (URI) overlap. A rapid test, if accurate in differentiating Sinusitis from URI, could be helpful in the diagnostic process. We examined the utility of nasopharyngeal cultures in identifying the subgroup of children with a clinical diagnosis of acute Sinusitis who are least likely to benefit from antimicrobial therapy (those with completely normal sinus radiographs). Nasopharyngeal swabs were collected from 204 children meeting a priori clinical criteria for acute Sinusitis. All children had sinus X-rays at the time of diagnosis. To determine if negative nasopharyngeal culture results could reliably identify the subgroup of children with normal radiographs, we calculated negative predictive values and negative likelihood ratios. Absence of pathogens in the nasopharynx was not helpful in identifying this low-risk subgroup.

  • acute Bacterial Sinusitis in children
    Pediatrics in Review, 2013
    Co-Authors: Gregory P. Demuri, Ellen R. Wald
    Abstract:

    Acute Bacterial Sinusitis is diagnosed in children with persistent rhinorrhea and cough, severe symptoms, or worsening of symptoms after initial improvement. Antibiotic therapy is recommended, and amoxicillin–clavulanate is generally the first-line treatment.

  • clinical practice guideline for the diagnosis and management of acute Bacterial Sinusitis in children aged 1 to 18 years
    Pediatrics, 2013
    Co-Authors: Ellen R. Wald, Kimberly E Applegate, Clay Bordley, David H Darrow, Mary P Glode, Michael S Marcy, Carrie E Nelson, Richard M Rosenfeld, Nader Shaikh, Michael Smith
    Abstract:

    OBJECTIVE: To update the American Academy of Pediatrics clinical practice guideline regarding the diagnosis and management of acute Bacterial Sinusitis in children and adolescents. METHODS: Analysis of the medical literature published since the last version of the guideline (2001). RESULTS: The diagnosis of acute Bacterial Sinusitis is made when a child with an acute upper respiratory tract infection (URI) presents with (1) persistent illness (nasal discharge [of any quality] or daytime cough or both lasting more than 10 days without improvement), (2) a worsening course (worsening or new onset of nasal discharge, daytime cough, or fever after initial improvement), or (3) severe onset (concurrent fever [temperature ≥39°C/102.2°F] and purulent nasal discharge for at least 3 consecutive days). Clinicians should not obtain imaging studies of any kind to distinguish acute Bacterial Sinusitis from viral URI, because they do not contribute to the diagnosis; however, a contrast-enhanced computed tomography scan of the paranasal sinuses should be obtained whenever a child is suspected of having orbital or central nervous system complications. The clinician should prescribe antibiotic therapy for acute Bacterial Sinusitis in children with severe onset or worsening course. The clinician should either prescribe antibiotic therapy or offer additional observation for 3 days to children with persistent illness. Amoxicillin with or without clavulanate is the first-line treatment of acute Bacterial Sinusitis. Clinicians should reassess initial management if there is either a caregiver report of worsening (progression of initial signs/symptoms or appearance of new signs/symptoms) or failure to improve within 72 hours of initial management. If the diagnosis of acute Bacterial Sinusitis is confirmed in a child with worsening symptoms or failure to improve, then clinicians may change the antibiotic therapy for the child initially managed with antibiotic or initiate antibiotic treatment of the child initially managed with observation. CONCLUSIONS: Changes in this revision include the addition of a clinical presentation designated as “worsening course,” an option to treat immediately or observe children with persistent symptoms for 3 days before treating, and a review of evidence indicating that imaging is not necessary in children with uncomplicated acute Bacterial Sinusitis.

Jay Piccirillo - One of the best experts on this subject based on the ideXlab platform.

  • psychometric evaluation of the sinonasal outcome test 16 and activity impairment assessment in acute Bacterial Sinusitis
    Otolaryngology-Head and Neck Surgery, 2013
    Co-Authors: N. Quadri, Beenish Nafees, Jay Piccirillo, Andrew Lloyd, Karen N. Keating, D. Wild
    Abstract:

    ObjectiveTo validate the Sinonasal Outcome Test-16 and Activity Impairment Assessment in patients with acute Bacterial Sinusitis.Study DesignData were used from a phase III clinical trial designed to evaluate the efficacy and safety of moxifloxacin 400 mg once daily for 5 consecutive days in the treatment of acute Bacterial Sinusitis. The psychometric properties and factor structure of the 2 measures were assessed.SettingParticipants were given the measures to self-complete using either a telephone voice response system or a paper-and-pencil format.Subjects and MethodsThree hundred seventy-four patients with acute Bacterial Sinusitis were used in the analysis. Patients received either a placebo or 400 mg moxifloxacin once daily. Patients were then reviewed at test of cure and follow-up. All analyses were conducted on a combined sample of placebo and active treatment patients.ResultsThe Sinonasal Outcome Test-16 was associated with minimal missing data at baseline but a higher proportion by test of cure. T...

  • Psychometric evaluation of the Sinonasal Outcome Test-16 and activity impairment assessment in acute Bacterial Sinusitis.
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2013
    Co-Authors: N. Quadri, Beenish Nafees, Jay Piccirillo, Andrew Lloyd, Karen N. Keating, D. Wild
    Abstract:

    OBJECTIVE: To validate the Sinonasal Outcome Test-16 and Activity Impairment Assessment in patients with acute Bacterial Sinusitis.\n\nSTUDY DESIGN: Data were used from a phase III clinical trial designed to evaluate the efficacy and safety of moxifloxacin 400 mg once daily for 5 consecutive days in the treatment of acute Bacterial Sinusitis. The psychometric properties and factor structure of the 2 measures were assessed.\n\nSETTING: Participants were given the measures to self-complete using either a telephone voice response system or a paper-and-pencil format.\n\nSUBJECTS AND METHODS: Three hundred seventy-four patients with acute Bacterial Sinusitis were used in the analysis. Patients received either a placebo or 400 mg moxifloxacin once daily. Patients were then reviewed at test of cure and follow-up. All analyses were conducted on a combined sample of placebo and active treatment patients.\n\nRESULTS: The Sinonasal Outcome Test-16 was associated with minimal missing data at baseline but a higher proportion by test of cure. There was no evidence of floor or ceiling effects and no significant skew. The Activity Impairment Assessment also had low missing data at baseline and no obvious floor or ceiling effects, but the data were not normally distributed. Both measures had good internal consistency. Convergent and divergent validity as well as sensitivity and the minimally important difference are also reported.\n\nCONCLUSION: The measures both have good psychometric properties and are suitable for use with patients with acute Bacterial Sinusitis. Both instruments are sensitive. The minimal important difference estimates for the Sinonasal Outcome Test-16 are quite high but are similar to estimates reported previously.

  • acute Bacterial Sinusitis
    The New England Journal of Medicine, 2004
    Co-Authors: Jay Piccirillo
    Abstract:

    A 43-year-old man has a two-week history of nasal congestion, postnasal drip, and fatigue. He has used an over-the-counter nasal decongestant and acetaminophen, without relief. During the past few days, facial pain and pressure have developed and have not responded to decongestants. In addition, his nasal discharge has turned from clear to yellow. How should he be treated?

D. Wild - One of the best experts on this subject based on the ideXlab platform.

  • psychometric evaluation of the sinonasal outcome test 16 and activity impairment assessment in acute Bacterial Sinusitis
    Otolaryngology-Head and Neck Surgery, 2013
    Co-Authors: N. Quadri, Beenish Nafees, Jay Piccirillo, Andrew Lloyd, Karen N. Keating, D. Wild
    Abstract:

    ObjectiveTo validate the Sinonasal Outcome Test-16 and Activity Impairment Assessment in patients with acute Bacterial Sinusitis.Study DesignData were used from a phase III clinical trial designed to evaluate the efficacy and safety of moxifloxacin 400 mg once daily for 5 consecutive days in the treatment of acute Bacterial Sinusitis. The psychometric properties and factor structure of the 2 measures were assessed.SettingParticipants were given the measures to self-complete using either a telephone voice response system or a paper-and-pencil format.Subjects and MethodsThree hundred seventy-four patients with acute Bacterial Sinusitis were used in the analysis. Patients received either a placebo or 400 mg moxifloxacin once daily. Patients were then reviewed at test of cure and follow-up. All analyses were conducted on a combined sample of placebo and active treatment patients.ResultsThe Sinonasal Outcome Test-16 was associated with minimal missing data at baseline but a higher proportion by test of cure. T...

  • Psychometric evaluation of the Sinonasal Outcome Test-16 and activity impairment assessment in acute Bacterial Sinusitis.
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2013
    Co-Authors: N. Quadri, Beenish Nafees, Jay Piccirillo, Andrew Lloyd, Karen N. Keating, D. Wild
    Abstract:

    OBJECTIVE: To validate the Sinonasal Outcome Test-16 and Activity Impairment Assessment in patients with acute Bacterial Sinusitis.\n\nSTUDY DESIGN: Data were used from a phase III clinical trial designed to evaluate the efficacy and safety of moxifloxacin 400 mg once daily for 5 consecutive days in the treatment of acute Bacterial Sinusitis. The psychometric properties and factor structure of the 2 measures were assessed.\n\nSETTING: Participants were given the measures to self-complete using either a telephone voice response system or a paper-and-pencil format.\n\nSUBJECTS AND METHODS: Three hundred seventy-four patients with acute Bacterial Sinusitis were used in the analysis. Patients received either a placebo or 400 mg moxifloxacin once daily. Patients were then reviewed at test of cure and follow-up. All analyses were conducted on a combined sample of placebo and active treatment patients.\n\nRESULTS: The Sinonasal Outcome Test-16 was associated with minimal missing data at baseline but a higher proportion by test of cure. There was no evidence of floor or ceiling effects and no significant skew. The Activity Impairment Assessment also had low missing data at baseline and no obvious floor or ceiling effects, but the data were not normally distributed. Both measures had good internal consistency. Convergent and divergent validity as well as sensitivity and the minimally important difference are also reported.\n\nCONCLUSION: The measures both have good psychometric properties and are suitable for use with patients with acute Bacterial Sinusitis. Both instruments are sensitive. The minimal important difference estimates for the Sinonasal Outcome Test-16 are quite high but are similar to estimates reported previously.

Tasnee Chonmaitree - One of the best experts on this subject based on the ideXlab platform.

  • Acute Bacterial Sinusitis Complicating Viral Upper Respiratory Tract Infection in Young Children
    Otolaryngology-Head and Neck Surgery, 2014
    Co-Authors: Tal Marom, Pedro E. Alvarez, Kristofer Jennings, Janak A. Patel, David P. Mccormick, Tasnee Chonmaitree
    Abstract:

    Objectives:(1) Analyze the clinical characteristics of upper respiratory infections (URIs) complicated by acute Bacterial Sinusitis (ABS) in young children. (2) Describe the bacteria and viruses isolated in nasopharyngeal specimens in children with ABS.Methods:We identified ABS episodes in a prospective, longitudinal cohort study of 294 children (aged 6-35 months at enrollment), who were followed up for one year to capture all URI episodes and complications. At the initial URI visit (median day = 4), nasopharyngeal samples were obtained for Bacterial cultures and viral studies. The study was conducted at the University of Texas Medical Branch, Galveston, during 2003-2007.Results:Of 1295 documented URI episodes, 103 (8%) episodes (in 73 children) were complicated by ABS, 32 of which were concurrent with acute otitis media. The majority (72%) of ABS episodes were diagnosed based on persistent symptoms or a biphasic course. The average age was 18.8 ± 7.2 months; white children were more likely to have ABS ep...

  • acute Bacterial Sinusitis complicating viral upper respiratory tract infection in young children
    Pediatric Infectious Disease Journal, 2014
    Co-Authors: Tal Marom, Kristofer Jennings, Janak A. Patel, David P. Mccormick, Pedro Alvarezfernandez, Tasnee Chonmaitree
    Abstract:

    BACKGROUND: Acute Bacterial Sinusitis (ABS) is a common complication of viral upper respiratory tract infections (URI). Clinical characteristics of URIs complicated by ABS in young children have not been well studied. METHODS: We identified ABS episodes in a prospective, longitudinal cohort study of 294 children (6-35 months of age at enrollment), who were followed up for 1 year to capture all URI episodes and complications. At the initial URI visit seen by the study personnel (median day = 4 from symptoms onset), nasopharyngeal samples were obtained for Bacterial cultures and viral studies. RESULTS: Of 1295 documented URI episodes, 103 (8%) episodes (in 73 children) were complicated by ABS, 32 of which were concurrent with acute otitis media. The majority (72%) of ABS episodes were diagnosed based on persistent symptoms or a biphasic course. Average age at ABS diagnosis was 18.8 ± 7.2 months; White children were more likely to have ABS episodes than Blacks (P = 0.01). Hispanic/Latino ethnicity (P < 0.0001) was negatively associated, and adequate 7-valent pneumococcal conjugate vaccine immunization status (P = 0.001) appeared to increase the risk of ABS. Girls had more ABS episodes than boys (0.5 ± 0.8 vs. 0.3 ± 0.6 episodes/yr, respectively, P = 0.03). Viruses were detected in 63% during the initial URI visit; rhinovirus detection was positively correlated with ABS risk (P = 0.01). Bacterial cultures were positive in 82/83 (99%) available samples obtained at the initial URI visit; polymicrobial (56%), Moraxella catarrhalis (20%) and Streptococcus pneumoniae (10%) were the most common cultures. Presence of pathogenic bacteria overall and presence of M. catarrhalis during URI were positively correlated with the risk for ABS (P = 0.04 for both). CONCLUSIONS: ABS complicates 8% of URI in young children. Girls have more frequent ABS episodes than boys. Presence of rhinovirus and M. catarrhalis during URI are positively correlated with the risk for ABS complication.

N. Quadri - One of the best experts on this subject based on the ideXlab platform.

  • psychometric evaluation of the sinonasal outcome test 16 and activity impairment assessment in acute Bacterial Sinusitis
    Otolaryngology-Head and Neck Surgery, 2013
    Co-Authors: N. Quadri, Beenish Nafees, Jay Piccirillo, Andrew Lloyd, Karen N. Keating, D. Wild
    Abstract:

    ObjectiveTo validate the Sinonasal Outcome Test-16 and Activity Impairment Assessment in patients with acute Bacterial Sinusitis.Study DesignData were used from a phase III clinical trial designed to evaluate the efficacy and safety of moxifloxacin 400 mg once daily for 5 consecutive days in the treatment of acute Bacterial Sinusitis. The psychometric properties and factor structure of the 2 measures were assessed.SettingParticipants were given the measures to self-complete using either a telephone voice response system or a paper-and-pencil format.Subjects and MethodsThree hundred seventy-four patients with acute Bacterial Sinusitis were used in the analysis. Patients received either a placebo or 400 mg moxifloxacin once daily. Patients were then reviewed at test of cure and follow-up. All analyses were conducted on a combined sample of placebo and active treatment patients.ResultsThe Sinonasal Outcome Test-16 was associated with minimal missing data at baseline but a higher proportion by test of cure. T...

  • Psychometric evaluation of the Sinonasal Outcome Test-16 and activity impairment assessment in acute Bacterial Sinusitis.
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2013
    Co-Authors: N. Quadri, Beenish Nafees, Jay Piccirillo, Andrew Lloyd, Karen N. Keating, D. Wild
    Abstract:

    OBJECTIVE: To validate the Sinonasal Outcome Test-16 and Activity Impairment Assessment in patients with acute Bacterial Sinusitis.\n\nSTUDY DESIGN: Data were used from a phase III clinical trial designed to evaluate the efficacy and safety of moxifloxacin 400 mg once daily for 5 consecutive days in the treatment of acute Bacterial Sinusitis. The psychometric properties and factor structure of the 2 measures were assessed.\n\nSETTING: Participants were given the measures to self-complete using either a telephone voice response system or a paper-and-pencil format.\n\nSUBJECTS AND METHODS: Three hundred seventy-four patients with acute Bacterial Sinusitis were used in the analysis. Patients received either a placebo or 400 mg moxifloxacin once daily. Patients were then reviewed at test of cure and follow-up. All analyses were conducted on a combined sample of placebo and active treatment patients.\n\nRESULTS: The Sinonasal Outcome Test-16 was associated with minimal missing data at baseline but a higher proportion by test of cure. There was no evidence of floor or ceiling effects and no significant skew. The Activity Impairment Assessment also had low missing data at baseline and no obvious floor or ceiling effects, but the data were not normally distributed. Both measures had good internal consistency. Convergent and divergent validity as well as sensitivity and the minimally important difference are also reported.\n\nCONCLUSION: The measures both have good psychometric properties and are suitable for use with patients with acute Bacterial Sinusitis. Both instruments are sensitive. The minimal important difference estimates for the Sinonasal Outcome Test-16 are quite high but are similar to estimates reported previously.