Comparable Efficacy of Azithromycin versus Ceftriaxone in Eradicating H. influenzae of Pediatric Nasal Carriers in Iraq

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Hayder Al-Anbari
Kadhum Al-Hilali
Meeaad Sughair

Abstract

Background: Haemophilus influenzae is a major cause of many serious infections. Nasal carriage contributes to upper respiratory tract infections. Its incidence in pediatric people is well detected worldwide. The guidelines for treatment include many classes of antimicrobial agents with graded response according to many factors. Patients and Methods: This study was carried out on 200 pediatric patients with an age range of 1-5 years, divided equally into 2 groups. Nasal swab was taken from both groups prior to medication, looking for H. influenzae. Nasal carriers in each group were defined. Then, the 1st group carriers were then subjected to treatment with ceftriaxone parenterally for 5 days in a dose of 50 mg/kg/d, while the carriers in the 2nd one were treated with azithromycin 200 mg/d orally for 5 days. After the treatment course, 2 days were left, and then another nasal swab was taken from each carrier child. Results: The swabs taken from both groups reveled the ability of both treatment regimens to eradicate H. influenza, with slightly better effect for azithromycin. Conclusion: The results obtained in this study clearly demonstrated the beneficial effect of using a 3rd generation cephalosporin or azithromycin in the eradication of H. influenzae and confirmed the role of antimicrobial agents in targeting the expected upper respiratory tract infections accompanying H. influenzae nasal carriage.

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Abboud, M. M., Aljundi, I. H., Khleifat, K. M., & Dmour, S. (2010). Biodegradation kinetics and modeling of whey lactose by bacterial hemoglobin VHb-expressing Escherichia coli strain. Biochemical Engineering Journal, 48(2), 166-172.

Adegbola RA, DeAntonio R, Hill PC, Roca A, Usuf E, Hoet B, Greenwood BM. Carriage of Streptococcus pneumoniae and other respiratory bacterial pathogens in low and lower-middle income countries: a systematic review and meta-analysis. PLoS One. 2014;9(8):e103293.

Al-Asoufi, A., Khlaifat, A., Tarawneh, A., Alsharafa, K., Al-Limoun, M., & Khleifat, K. (2017). Bacterial quality of urinary tract infections in diabetic and non-diabetics of the population of Ma'an Province, Jordan. Pakistan J Biol Sci, 20, 179-88.

Althunibat, O. Y., Qaralleh, H., Al-Dalin, S. Y. A., Abboud, M., Khleifat, K., Majali, I. S., ... & Jaafraa, A. (2016). Effect of thymol and carvacrol, the major components of Thymus capitatus on the growth of Pseudomonas aeruginosa. J Pure Appl Microbiol, 10, 367-74.

Bakir M, Yagci A, Ulger N, Akbenlioglu C, Ilki A, Soyletir G, et al. Pharyngeal colonization with Haemophilus influenzae type b among healthy Turkish infants and children. Pediatr Intern 2002;44:381-6.

Barbour ML. Conjugate vaccines and the carriage of Haemophilus influenzae type b. Emerg Infect Dis 1996;2:1-9.

Biedenbach DJ, Jones RN, Pfaller MA, Sentry Participants G. Activity of BMS284756 against 2,681 recent clinical isolates of Haemophilus influenzae and Moraxella catarrhalis: Report from The SENTRY Antimicrobial Surveillance Program (2000) in Europe, Canada and the United States. Diagn Microbiol Infect Dis. 2001;39(4):245–50.

Blosser-Middleton R, Sahm DF, Thornsberry C, Jones ME, Hogan PA, Critchley IA, et al. Antimicrobial susceptibility of 840 clinical isolates of Haemophilus influenzae collected in four European countries in 2000-2001. Clin Microbiol Infect 2003; 9:431-6.

Bradley, J. S. 2002. Management of community-acquired pediatric pneumonia in an era of increasing antibiotic resistance and conjugate vaccines. Pediatr. Infect. Dis. J. 21:592-598.

Deguchi T, Ito S, Hatazaki K, Horie K, Yasuda M, Nakane K, et al. Antimicrobial susceptibility of Haemophilus influenzae strains isolated from the urethra of men with acute urethritis and/or epididymitis. J Infect Chemother. 2017 Jun 12.

Diavatopoulos DA, Short KR, Price JT, Wilksch JJ, Brown LE, Briles DE, Strugnell RA, Wijburg OL. Influenza A virus facilitates Streptococcus pneumoniae transmission and disease. FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology. 2010;24(6):1789–98.

Garcia-Rodriguez JA, Fresnadillo Martinez MJ. Dynamics of nasopharyngeal colonization by potential respiratory pathogens. J Antimicrob Chemother. 2002;50(Suppl S2):59–73.

Gehanno P, Lenoir G, Barry B, Bons J, Boucot I, Berche P. Evaluation of nasopharyngeal cultures for bacteriologic assessment of acute otitis media in children. Pediatr Infect Dis 1996;15:329-32.

Granoff DM, Daum RS. Spread of Haemophilus influenzae type b: recent epidemiologic and therapeutic considerations. Pediatrics 1980;97:854-860.

Homady, M. H., Khleifat, K. M., Tarawneh, K. A., & Al-Raheil, I. A. (2002a). Reproductive toxicity and infertility effect of Ferula hormonis extracts in mice. Theriogenology, 57(9), 2247-2256.

Homady, M., Hussein, H., Jiries, A., Mahasneh, A., Al-Nasir, F., & Khleifat, K. (2002b). Survey of some heavy metals in sediments from vehicular service stations in Jordan and their effects on social aggression in prepubertal male mice. Environmental research, 89(1), 43-49.

Howard AF, Dunkin KT, Millar GW. Nasopharyngeal carriage and antibiotic resistance of Haemophilus influenzae in healthy children. Epidemiol Infect 1988;100:193-203.

Johnson DM, Sader HS, Fritsche TR, Biedenbach DJ, Jones RN. usceptibility trends of haemophilus influenzae and Moraxella catarrhalis against orally administered antimicrobial agents: five-year report from the SENTRY Antimicrobial Surveillance Program. Diagn Microbiol Infect Dis. 2003;47(1):373–6.

Jones, A.M., 1982. Haemophilus influenzae and H. parainfluenzae: The Influence of Media and CO2 on Differentiation Using X,V and XV Discs. Med. Lab. Sci., Vol. 39, pp.189-191.

Katzung basic & clinical pharmacology: Katzung B G, Masters S B, and Trevor A J. 12th edition (International edition 2012). Mc Graw Hill Education (Asia)

Khleifat, K. M. (2006). Correlation Between Bacterial Hemoglobin and Carbon Sources: Their Effect on Copper Uptake by Transformed E. coli Strain ?DH5. Current microbiology, 52(1), 64-68.

Khleifat, K. M., Abboud, M. M., Al-Mustafa, A. H., & Al-Sharafa, K. Y. (2006b). Effects of Carbon Source and Vitreoscilla Hemoglobin (VHb) on the Production of ?-galactosidase in Enterobacter aerogenes. Current microbiology, 53(4), 277.

Khleifat, K. M., Abboud, M. M., Omar, S. S., & Al-Kurishy, J. H. (2006a). Urinary tract infection in South Jordanian population. J Med Sci, 6, 5-11.

Khleifat, K. M., Hanafy, A. M. M., & Al Omari, J. (2014). Prevalence and molecular diversity of Legionella pneumophila in domestic hot water systems of private apartments. British Microbiology Research Journal, 4(3), 306.

Khleifat, K. M., Matar, S. A., Jaafreh, M., Qaralleh, H., Al-limoun, M. O., & Alsharafa, K. Y. (2019). Essential Oil of Centaurea damascena Aerial Parts, Antibacterial and Synergistic Effect. Journal of Essential Oil Bearing Plants, 22(2), 356-367.

Khleifat, K., Abboud, M., Al-Shamayleh, W., Jiries, A., & Tarawneh, K. (2006c). Effect of chlorination treatment on gram negative bacterial composition of recycled wastewater. Pak. J. Biol. Sci, 9, 1660-1668.

Khleifat, K., Shakhanbeh, J., & TARAWNEH, K. A. (2002). The chronic effects of Teucrium polium on some blood parameters and histopathology of liver and kidney in the rat. Turkish journal of Biology, 26(2), 65-71.

Kilian, M., 1976. A Taxonomic Study of the Genus Haemophilus, with the Proposal of A New Species. J. Gen. Microbial., Vol. 93, pp.63-68

Koneman, E.W., Allen, S.D., Dowell, V.R., Janda, W.M., Sommers, H.M. and Winn,W.C., 1989. Color Atlas and Textbook of Diagnostic Microbiology. LippincottRaven Publishers. U.S.A.

Leach AJ, Boswell JB, Asche V, Nienhuys TG, Mathews JD. Bacterial colonization of the nasopharynx predicts very early onset and persistenceof otitis media in Australian aboriginal infants. Pediatr Infect Dis J. 1994; 13(11):983–9.

Lerman SJ, Kucera JC, Brunken JM. Nasopharyngeal carriage of antibiotic resistant Haemophilus influenzae in health children. Pediatrics 1979;64:287-90.

Li JP, Hua CZ, Sun LY, Wang HJ, Chen ZM, Shang SQ. Epidemiological Features and Antibiotic Resistance Patterns of Haemophilus influenzae Originating from Respiratory Tract and Vaginal Specimens in Pediatric Patients. J Pediatr Adolesc Gynecol. 2017 Jun 16.

Li KI, Dashefsky B, Wald ER. Haemophilus influenzae type b colonization in household contacts of infected and colonized children enrolled in day care. Pediatrics 1986;78:15-20.

Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar. 131 (3).

Majali, I. S., Oran, S. A., Khaled, M. K., Qaralleh, H., Rayyan, W. A., & Althunibat, O. Y. (2015). Assessment of the antibacterial effects of Moringa peregrina extracts. African Journal of microbiology research, 9(51), 2410-2414.

Michaels RH, Poziviak CS, Stonebraker FE, Norden CW. Factors affecting pharyngeal Haemophilus influenzae type b colonization rates in children. J Clin Microbiol 1976;4:413-7.

Murphy TV, Pastor P, Medley F, Osterholm MT, Granoff DM. Pharyngeal colonization with Haemophilus influenzae type b in children in a day care center without invasive disease. J Pediatr 1985;106:712-6.

O'Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N, Lee E, Mulholland K, Levine OS, Cherian T, et al. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet. 2009;374(9693):893–902.

Qaralleh, H. N., Abboud, M. M., Khleifat, K. M., Tarawneh, K. A., & Althunibat, O. Y. (2009). Antibacterial activity in vitro of Thymus capitatus from Jordan. Pakistan journal of pharmaceutical sciences, 22(3).

Qaralleh, H., Idid, S., Saad, S., Susanti, D., Taher, M., & Khleifat, K. (2010). Antifungal and antibacterial activities of four Malaysian sponge species (Petrosiidae). Journal de Mycologie Médicale, 20(4), 315-320.

Shuichi Miyazaki Toshihiko Fujikawa Tetsuya Matsumoto Kazuhiro Tateda Keizo Yamaguchi: Efficacy of azithromycin, clarithromycin and ?-lactam agents against experimentally induced bronchopneumonia caused by Haemophilus influenzae in mice. Journal of Antimicrobial Chemotherapy, Volume 48, Issue 3, 1 September 2001, Pages 425–430.

Singleton R, Hammitt L, Hennessy T, et al. The Alaska Haemophilus influenzae type b experience: lessons in controlling a vaccine – preventable disease. Pediatrics. 2006 Aug. 118(2).

Tarawneh, K. A., Al?Tawarah, N. M., Abdel?Ghani, A. H., Al?Majali, A. M., & Khleifat, K. M. (2009). Characterization of verotoxigenic Escherichia coli (VTEC) isolates from faeces of small ruminants and environmental samples in Southern Jordan. Journal of basic microbiology, 49(3), 310-317.

Thornsberry C, Ogilvie PT, Holley HP Jr, Sahm DF. Survey of susceptibilities of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Isolates to 26 antimicrobial agents: a prospective US Study, Antim Agent Chem 1999;43:2612-23.

Tribuddharat C, Srifuengfung S. Multiple drug resistance in Haemophilus influenzae isolated from patients in Bangkok, Thailand. J Glob Antimicrob Resist. 2017 Jun. 9:121-123.

Waters D, Jawad I, Ahmad A, Luksic I, Nair H, Zgaga L, Theodoratou E, Rudan I, Zaidi AK, Campbell H. Aetiology of community-acquired neonatal sepsis in low and middle income countries. Journal of global health. 2011;1(2):154–70.

Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, Nouwen JL. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis. 2005;5(12):751–62.

World Health O. WHO position paper on Haemophilus influenzae type b conjugate vaccines. (Replaces WHO position paper on Hib vaccines previously published in the Weekly Epidemiological Record). Releve epidemiologique hebdomadaire/Section d'hygiene du Secretariat de la Societe des Nations = Weekly epidemiological record/Health Section of the Secretariat of the League of Nations. 2006;81(47):445–52.

Zanella RC, Casagrande ST, Bokermann S, Almeida SC, Brandileone MC. Characterization of Haemophilus influenzae isolated from invasive disease in Brazil from 1990 to 1999. Microb Drug Resist 2002;8;67-72.

Zeidan, R., Oran, S., Khleifat, K., & Matar, S. (2013). Antimicrobial activity of leaf and fruit extracts of Jordanian Rubus sanguineus Friv.(Rosaceae). African Journal of Microbiology Research, 7(44), 5114-5118.