title: Role of nontypeable Haemophilus influenzae in pediatric respiratory tract infections.
abstract: BACKGROUND
  Nontypeable strains of Haemophilus influenzae may spread contiguously from the upper respiratory tract and cause sinusitis, otitis media and pneumonia. Unlike H. influenzae type b these strains rarely invade the bloodstream to cause widespread infections. These strains are primary pathogens of acute otitis media, sinusitis and the conjunctivitis-otitis syndrome. In developing countries these strains are also responsible for many cases of pediatric pneumonia. Currently approximately 30% of nontypeable H. influenzae strains are beta-lactamase-positive and can inactivate susceptible penicillins, including penicillins G and V, ampicillin and amoxicillin. Most second generation oral cephalosporins are active against beta-lactamase-producing H. influenzae. Some third generation oral cephalosporins, e.g. cefixime, however, have particularly good efficacy against H. influenzae. Sulfonamides and chloramphenicol are generally effective as well.
  
  
  CONCLUSIONS
  Until a vaccine that provides adequate prophylaxis against nontypeable H. influenzae is developed, clinicians should be guided by knowledge of bacterial susceptibility and microbiologic efficacy in choosing appropriate agents for treating pediatric infections likely to involve this common pathogen.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, MA, USA.
authors.forename: J O
authors.initials: JO
authors.lastname: Klein
mesh_terms: D002648:Child; D004352:Drug Resistance, Microbial; D006192:Haemophilus Infections / Q000188:drug therapy / Q000517:prevention & control; D018073:Haemophilus Vaccines; D006193:Haemophilus influenzae / Q000145:classification / Q000187:drug effects / Q000472:pathogenicity; D006801:Humans; D008583:Meningitis, Haemophilus; D010033:Otitis Media / Q000382:microbiology; D018410:Pneumonia, Bacterial; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology*; D018805:Sepsis; D012852:Sinusitis
chemical_list: D018073:Haemophilus Vaccines