The clinical manifestations of Haemophilus influenzae infections and the growing problem of ampicillin-resistant strains are reviewed. Despite the fact that approximately 25 percent of H.influenzae are resistant to penicillin and ampicillin, oral aminopenicillins (ampicillin, amoxicillin, bacampicillin, and cyclacillin) are commonly used for the outpatient management of these infections. The characteristics of these drugs and the rationale for their use are discussed and compared with alternative approaches to therapy. This subject requires periodic review in consideration of the increasing prevalence of ampicillin and multiple antibiotic resistance among H. influenzae isolates.
Get full access to this article
View all access options for this article.
References
1.
Williams M., Thompson Abr.Fatal Haemophilus influenzae type f infection. Lancet1982; 1:630.
2.
Ginsburg CM, Howard JB, Nelson JDReport of 65 cases of Haemophilus influenzae b pneumonia. Pediatrics1979;64:283-6.
3.
Schiffer MS, Schneerson R., MacLawry J., et al. Clinical bacteriological, and immunological characterisation of ampicillin-resistant Haemophilus influenzae type b. Lancet1974;2:257-9.
4.
Malmvall BE, Branefors-Helander P.R-factor involvement in a local outbreak of ampicillin-resistant Haemophilus influenzae infections. Scand J Infect Dis1978;10:53-6.
5.
Abbott GD, Faoagali JLH. influenzae type b resistant to ampicillin. NZ Med J1977;86:301.
6.
Dabernat H.Résultats de l'enquete multicentrique concernant la sensibilité aux antibiotiques . Pathol Biol1983;31: 77-9.
7.
Mehtar S., Aminiafshar S.Antibiotic resistance amongst various types of Haemophilus species . J Antimicrob Chemother1983;12:565-70.
8.
Moxen ERImmunology of Haemophilus influenzae infections. In: Nahmias AJ, O'Reilly RJ, eds. Immunology of human infection. Part I: bacteria, mycoplasmae, chlamydiae, and fungi. New York: Plenum Medical Book Company, 1981:113-38.
9.
Kaplan SL, Umstead CL, Mason EO, et al. Assessment of Haemophilus influenzae type b opsonins by neutrophil chemiluminescence. J Clin Microbiol1981;13:532-9.
10.
Daum RS, Siber GR, Kamon JS, et al. Evaluation of a commercial latex particle agglutination test for rapid diagnosis of Haemophilus influenzae type b infection. Pediatrics1982;69:466-71.
11.
Schwartz R. , Rodriguez W., Khan W., et al.The increasing incidence of ampicillin-resistant Haemophilus influenzae. JAMA1978;239:320-3.
12.
Sokol RJ, Bowden RAAn erysipelas-like scalp cellulitis due to Haemophilus influenzae type b. J Pediatr1980;96:60-1.
13.
Bluestone CDDiagnosis and management of the child with persistent middle ear effusion. Pediatr Infect Dis1982 ; 1:S97.
14.
Klein JOPersistent middle ear effusian: natural history and morbidity. Pediatr Infect Dis1982;1:S37.
15.
Nelson JD, Haltalin KCAmoxicillin less effective than ampicillin against Shigella in vitro and in vivo: Relationship of efficacy to activity in serum. J Infect Dis [Suppl] 1974;129:S222-7.
16.
Sjovall J., Magni L., Bergan T.Pharmacokinetics of bacampicillin compared with those of ampicillin, pivampicillin, and amoxycillin. Antimicrob Agent Chemother1978; 13:90-6.
17.
Ginsburg CM , McCracken GH Jr, Clahsen J., et al. Comparative pharmacokinetics of bacampicillin and ampicillin suspensions in infants and children. Rev Infect Dis1981;3:117-20.
18.
Neu HCThe pharmacokinetics of bacampicillin. Rev Infect Dis1981;3:110-6.
19.
Tan JS, Salstrom SJ, File TMJr. Levels of antibiotic in human blood and interstitial fluid after oral administration of bacampicillin or phenoxymethyl penicillin and intravenous administration of amoxicillin or ampicillin. Rev Infect Dis1981;3:121-4.
20.
Virtanen S. , Lalukainen EAAmpicillin concentrations in middle ear effusions in acute otitis media after administration of bacampicillin . Infection1979;7:5472-3.
21.
Finegold SM , Gentry LO, Mogabgab W., et al. Controlled comparative trial of bacampicillin and amoxicillin in therapy of bacterial infections of the lower respiratory tract. Rev Infect Dis1981;3:150-3.
22.
Pankey GA, Gleason C., File TM Jr et al. A comparative study of bacampicillin hydrochloride, penicillin V, and amoxicillin in the treatment of acute tonsillitis and/or pharyngitis due to β-hemolytic streptococci. Rev Infect Dis1981;3:154-8.
23.
Richard GA, Iravani A., LeFroek JL, et al. Bacampicillin vs. amoxicillin for treatment of acute infections of the urinary tract. Rev Infect Dis1981;3:159-65.
24.
Wagner KF, Counts G., Holmes KK, et al. Clinical evaluation of single-dose oral bacampicillin or ampicillin in therapy of uncomplicated gonorrhea. Rev Infect Dis1981;3: 166-9.
25.
Ginsburg CM , McCracken GH Jr, Zweighaft TC, et al. Comparative pharmacokinetics of cyclacillin and amoxicillin in infants and children. Antimicrob Agent Chemother198 1; 19: 1086-8.
26.
Editorial.Cyclacillin (cyclapen)—Another new penicillin. Med Lett1980;22:13-4.
27.
Sinai R., Hammerberg S., Marks MI, et al. In vitro susceptibility of Haemophilus influenzae to sulfamethoxazole-trimethoprim and cefaclor, cephalexin, and cephradine. Antimicrob Agent Chemother1978;13:861-4.
28.
Yogev R., Moxon ERElaboration of type b capsule by Haemophilus influenzae as a determinant of pathogenicity and impaired killing by trimethoprim-sulfamethoxazole. J Clin Invest1982;69:658-65.
29.
Laferriere CI, Marks MIChloramphenicol: properties and clinical use . Pediatr Infect Dis1982:1:257-64.
30.
Smith ALAntibiotic resistance in Haemophilus influenzae. Pediatr Infect Dis1983;2:352-5.
31.
Marqués JC, Garcia-Tornel S., Tahull Jmg.Invasive infections caused by multiply resistant Haemophilus influenzae type b. J Pediatr1984;104:162.
32.
Yogev R., Melick C., Kabat WJIn vitro and in vivo synergism between amoxicillin and clavulanic acid against ampicillin-resistant Haemophilus influenzae type b. Antimicrob Agent Chemother1981;19:993-6.
33.
Brogden RN, Carmine A., Heel RC, et al. Amoxycillin/ clavulanic acid: a review of its antibacterial activity, pharmacokinetics and therapeutic use. Drugs1981;22:337-62.
34.
Fleisher GR , Wilmott CM, Campos JMAmoxicillin combined with clavulanic acid for the treatment of soft tissue infections in children . Antimicrob Agent Chemother1983;24:679-81.
35.
Pien FDDouble-blind comparative study of two dosage regimens of cefaclor and amoxicillin-clavulanic acid in the outpatient treatment of soft tissue infections. Antimicrob Agent Chemother1983 ;24:856-9.
36.
Marks MI, Weinmaster G.Influences of media and inocula on the in vitro susceptibility of Haemophilus influenzae to co-trimoxaxote, ampicillin, penicillin, and chloramphenicol . Antimicrob Agent Chemother1975;8:657-63.
37.
Schwartz RH , Rodriguez WJ, Bryan C.Ampicillin-resistant Haemophilus in the oropharynx: prevalence in three groups of young, middle-class children. Pediatrics1983;72: 464-8.
38.
Hansman D.Haemophilus influenzae type b resistant to tetracycline isolated from children with meningitis. Lancet1975;2:893-6.
39.
Khan W., Ross S., Rodriguez W., et al. Haemophilus influenzae type b resistant to ampicillin. JAMA1974;229:298-301.
40.
Tomeh MO, Starr SE, McGawan JE Jr, et al. Ampicillin-resistant Haemophilus influenzae type b infection . JAMA1974:229:295-301.
Centers for Disease Control.Ampicillin-resistant Haemophilus influenzae—Texas. MMWR1974;23:99.
43.
Ward JI, Tsai TF, Filice GA, et al. Prevalence of ampicillin and chloramphertical-resistant strains of Haemophilus influenzae causing meningitis and bacteremia: national survey of hospital laborataries. J Infect Dis1978 ; 138:421-4.
44.
Elwell LP, DeGraaff J., Seibert D., et al. Plasmid-linked ampicillin resistance in Haemophilus influenzae type b. Infect Immun1975:12:404-10.
45.
Vega R., Sadoff HL, Patterson MJMechanisms of ampicillin resistance in Haemophilus influenzae type b. Antimicrob Agent Chemother1976;9:164-8.
46.
Saunders JR , Sykes RBTransfer of a plasmid-specified betalactarnase gene from Haemophilus influenzae. Antimicrob Agent Chemother1977; 11:339-44.
47.
Michaels RHAmpicillin-resistant Haemophilus influenzae and otitis media. Am Dis Child1981;135:403-5.
48.
Kaplan SL, Mason EO, Kvernland SJEffect of prior antibiotics on the susceptibility of Haemophilus influenzae type b to ampicillin. Pediatrics1981:67:269-71.
49.
Scheifele DW , Syriopoulou VP, Harding AL, et al. Evaluation of a rapid β-lactamase test for detecting ampicillin-resistant strains of Hemophilus influenzae type b. Pediatrics1976 ; 58:382-7.
50.
Tiltan RC, Kwasnik I., Ryan R.Comparison of rapid methods of antimicrobial susceptibility in Haemophilus influenzae. Ann Clin Lab Sci1978;8:70-3.
51.
Delage G., Gaudreau C.Mixed infections with Hemophilus influenzae type b. Can Med Assoc J1979;121:1167-8.
52.
Jubelirer DP , Yeager ASSimultaneous recovery of ampicillin-sensitive and ampicillin-resistant organisms in Haemophilus influenzae type b meningitis . J Pediatr1979;95:415-6.
53.
Mason EO Jr, Kaplan SL, Anderson DC, et al. In vitro susceptibility of 104 clinical isolates of Haemophilus influenzae to moxalactam (LY127935), ampicillin, chloramphenicol, and ticarcillin. Antimicrob Agent Chemother1980;17:470-3.
54.
Syriopoulou V., Scheifele D., Smith AL, et al. Increasing incidence of ampicillin resistance in Hemophilus influenzae. J Pediatr1978;92:889-92.
55.
Gustafson TL , Kelley RA, Hutcheson RH Jr, et al. Statewide survey of the antimicrobial susceptibilities of Haemophilus influenzae producing invasive disease in Tennessee . Pediatr Infect Dis1983;2:119-22.
56.
Centers for Disease Control.Ampicillin and chloramphenicol resistance in systemic Haemophilus influenzae disease. MMWR1984;33:35-7.
57.
Roberts MC, Swenson CD, Owens LM, et al. Characterization of chloramphenicol-resistant Haemophilus influenzae . Antimicrob Agent Chemother1980; 18:610-15.
58.
Bryan LETransferable chloramphenicol and ampicillin resistance in a strain of Haemophilus influenzae. Antimicrob Agent Chemother1978 ;14:154-6.
59.
Kenny JF, Isburg CD, Michaels RHMeningitis due to Haemophilus influenzae type b resistant to both ampicillin and chloramphenicol. Pediatrics1980;66:14-6.
60.
Uchiyama N. , Greene GR, Kitts DB, et al. Meningitis due to Haemophilus influenzae type b resistant to ampicillin and chloramphenicol . J Pediatr1980;97:421-4.
61.
Simasathien S.Haemophilus influenzae type b resistant to ampicillin and chloramphenicol in an orphanage in Thailand. Lancet1980;2:1214-7.
62.
Marks MI, Vose ADEvaluation of amoxieillin therapy in ill children. J Clin Pharmacol1978;18:61.
63.
Editorial.Bacampicillin hydrochloride (spectrobid). Med Lett1981;23:49-50.
64.
Bergan T.Pharmacokinetic comparison of oral bacampicillin and parenteral ampicillin . Antimicrob Agent Chemother1978; 13:971-4.
65.
May JR, Davies J.Resistance of Haemophilus influenzae to trimethoprim. Br Med J1972; 14:376-7.
66.
Murphy TV, McCracken GH Jr, Zweighaft TC, et al. Emergence of rifampin-resistant Haemophilus influenzae after prophylaxis. J Pediatr198 1;99:406-9.
67.
Long SS, Phillips SEChloramphenicol-resistant Hemophilus influenzae. J Pediatr1977;90:1030-1.
68.
Rubin LG, Yolken RH, Medeiros AA, et al. Ampicillin treatment failure of apparently β-lactamase-negative Haemophilus influenzae type b meningitis due to novel β-lactamase. Lancet1981;2:1008-10.
69.
Offit PA, Campos JM, Plotkin SAAmpicillin-resistant β-lactamase-negative Haemophilus influenzae type b. Pediatrics1982;69:230-2.
70.
Bell SM, Plowman D.Mechanisms of ampicillin resistance in Haemophilus influenzae from respiratory tract. Lancet1980;1:279-80.
71.
Halsey NA, Glode MP, Johansen T., et al. Haemophilus influenzae type b resistant to ampicillin and chloramphenicol (abstract). Pediatr Res1980; 14:558.
