The Experts below are selected from a list of 6078 Experts worldwide ranked by ideXlab platform
Ian C K Wong - One of the best experts on this subject based on the ideXlab platform.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND: Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE: To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS: We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS: There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 ( approximately 1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS: Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND. Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE. To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS. We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS. There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 (∼1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS. Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
Sheldon L Kaplan - One of the best experts on this subject based on the ideXlab platform.
-
R451 – Pediatric Pneumococcal Mastoiditis and Serotype 19A: Update
Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Julina Ongkasuwan, Tulio A Valdez, Kristina G Hulten, Edward O Mason, Sheldon L KaplanAbstract:ProblemStreptococcus pneumoniae is the primary cause of pediatric Mastoiditis. Since the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, the serotypes causing invasive infections have shifted. We are following the impact of PCV7 on pneumococcal Mastoiditis at Texas Children's Hospital (TCH). Previously, a non-vaccine serotype, 19A and specifically a multidrug resistant clonotype, CC271, was identified as the predominant cause of Mastoiditis during the 2006–07 academic year.MethodsThe medical records of children with pneumococcal Mastoiditis between July 2007 and February 2008 (prospective through June 2008) were reviewed. Isolates were serotyped by the capsular swelling method and compared to previously collected data since January 1995.ResultsSix Mastoiditis cases have been identified thus far in 2007–08; 19A has been the only isolated serotype. This is comparable to the number of cases identified at this point last year. Of the 15 total isolates in 2006–07, all but 2 were attributable to 19A. Fo...
-
pneumococcal Mastoiditis in children and the emergence of multidrug resistant serotype 19a isolates
Pediatrics, 2008Co-Authors: Julina Ongkasuwan, Tulio A Valdez, Kristina G Hulten, Edward O Mason, Sheldon L KaplanAbstract:OBJECTIVE. We review the impact of pneumococcal conjugate vaccine on pneumococcal Mastoiditis in children at Texas Children's Hospital. METHODS. The medical charts (including the number of pneumococcal conjugate vaccine doses) for children with pneumococcal Mastoiditis treated at Texas Children's Hospital between January 1995 and June 2007 were reviewed retrospectively. Isolates were serotyped with the capsular swelling method. Pulsed-field gel electrophoresis was performed on the 19A isolates and multilocus sequence typing on selected 19A clones. RESULTS. Forty-one pneumococcal Mastoiditis cases were identified, and 19A (n = 19) was the most common serotype. Before the introduction of pneumococcal conjugate vaccine (from 1995 to December 1999), 0 of 12 cases were 19A. Between April 2000 and October 2006, 15 cases of pneumococcal Mastoiditis occurred, and 5 were 19A. Fourteen cases of pneumococcal Mastoiditis occurred between November 2006 and June 2007, all of which were 19A. Mastoiditis caused by 19A isolates was more likely to present with subperiosteal abscess and was more likely to need intraoperative mastoidectomy than was Mastoiditis caused by non-19A isolates. Multidrug resistance was also common among the 19A isolates; 13 (68%) of the 19A isolates were resistant to all antibiotics tested routinely. Pulsed-field gel electrophoresis analysis placed 14 (74%) of the 19 serotype 19A isolates into a highly related group; 12 isolates were classified as closely related, and 2 were possibly related. Multilocus sequence typing analysis placed the pulsed-field gel electrophoresis cluster isolates into clonal complex 271 (sequence types 320 and 1451). CONCLUSIONS. At Texas Children's Hospital, 19A has become the predominant serotype causing pneumococcal Mastoiditis, partly related to the emergence of multidrug-resistant clonal complex 271 strains. Subperiosteal abscesses and the need for mastoidectomy were more common in children with Mastoiditis caused by serotype 19A isolates, compared with isolates of other serotypes.
-
Pneumococcal Mastoiditis in children.
Pediatrics, 2000Co-Authors: Sheldon L Kaplan, Edward O Mason, Ellen R. Wald, Kwang Sik Kim, Laurence B. Givner, John S. Bradley, William J. Barson, Tina Q. Tan, Gordon E. Schutze, Ram YogevAbstract:Objective. To determine the impact of antibiotic resistance on the frequency, clinical features, and management/outcome of Mastoiditis attributable to Streptococcus pneumoniae. Design. Retrospective review of the medical records of children with Mastoiditis caused by S pneumoniae from September 1993 through December 1998. Patients. Infants and children with pneumococcal Mastoiditis cared for at 8 children9s hospitals in the United States. Results. Thirty-four children with pneumococcal Mastoiditis were identified. The median age of the children was 12 months (range: 2 months–12.5 years); 28 (82%) were ≤2 years old. Six children had recurrent otitis media. A subperiosteal abscess was noted in 13 children (37%). The mastoids were abnormal in all 25 patients on whom computed tomography was performed. There was no trend toward increasing numbers of cases per year despite increasing proportions of pneumococcal isolates, which were nonsusceptible to penicillin. Serogroup 19 accounted for 57% of isolates, serogroup 23 for 14.3% of isolates, and serotype 3 for 10.7% of isolates. Except for receipt of less antibiotic therapy in the previous 30 days, children with penicillin-susceptible isolates had similar demographic features and clinical findings and surgical treatment as did children whose isolates were nonsusceptible to penicillin. Conclusions. Pneumococcal Mastoiditis occurs primarily in children
Paula L Thompson - One of the best experts on this subject based on the ideXlab platform.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND: Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE: To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS: We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS: There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 ( approximately 1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS: Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND. Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE. To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS. We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS. There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 (∼1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS. Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
Ruth Gilbert - One of the best experts on this subject based on the ideXlab platform.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND: Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE: To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS: We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS: There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 ( approximately 1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS: Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND. Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE. To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS. We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS. There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 (∼1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS. Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
Paul F Long - One of the best experts on this subject based on the ideXlab platform.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND: Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE: To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS: We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS: There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 ( approximately 1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS: Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.
-
effect of antibiotics for otitis media on Mastoiditis in children a retrospective cohort study using the united kingdom general practice research database
Pediatrics, 2009Co-Authors: Paula L Thompson, Ruth Gilbert, Paul F Long, Sonia Saxena, Mike Sharland, Ian C K WongAbstract:BACKGROUND. Information is needed on whether Mastoiditis has increased in association with the decline in antibiotics prescribed to children by primary care physicians in the United Kingdom. OBJECTIVE. To determine time trends in Mastoiditis incidence, the frequency of antecedent otitis media, and the effect of antibiotics for otitis media on the risk of Mastoiditis in children. PATIENTS AND METHODS. We conducted a retrospective cohort study by using the UK General Practice Research Database. Children aged 3 months to 15 years between 1990 and 2006 were included. Risk of Mastoiditis within 3 months after otitis media diagnosis and the protective effect of antibiotics were determined. RESULTS. There were 2 622 348 children within the General Practice Research Database; 854 had Mastoiditis, only one third of whom (35.7%) had antecedent otitis media. Mastoiditis incidence remained stable between 1990 and 2006 (∼1.2 per 10 000 child-years). Risk of Mastoiditis, after otitis media, was 1.8 per 10 000 episodes (139 of 792 623) after antibiotics compared with 3.8 per 10 000 (149 of 389 649) without antibiotics, and increased with age. Antibiotics halved the risk of Mastoiditis. General practitioners would need to treat 4831 otitis media episodes with antibiotics to prevent 1 child from developing Mastoiditis. If antibiotics were no longer prescribed for otitis media, an extra 255 cases of childhood Mastoiditis would occur, but there would be 738 775 fewer antibiotic prescriptions per year in the United Kingdom. CONCLUSIONS. Most children with Mastoiditis have not seen their general practitioner for otitis media. Antibiotics halve the risk of Mastoiditis, but the high number of episodes needing treatment to prevent 1 case precludes the treatment of otitis media as a strategy for preventing Mastoiditis. Although Mastoiditis is a serious disease, most children make an uncomplicated recovery after mastoidectomy or intravenous antibiotics. Treating these additional otitis media episodes could pose a larger public health problem in terms of antibiotic resistance.