Haemophilus influenzae causes upper respiratory tract infections that can develop into potentially fatal infections of the brain, bloodstream, lungs and bones. The World Health Organization estimates that Haemophilus influenzae is responsible for about 3 million illnesses and some 386 000 deaths per year worldwide. With the introduction of preventive vaccines in 1988, however, the incidence of these infections have diminished to less than one case per 100,000 children in the U.S. The infection is still prevalent among elders, unvaccinated children and in immunocompromised individuals.
Antibiotics
Antibiotics are the first line of defense against Haemophilus influenzae infections. Individuals with mild infections of Haemophilus influenzae such as ear infection, bronchitis and sinusitis, do not require hospitalization and can be treated completely by using oral antibiotics for 10 to 14 days.The John Hopkins Point-of-Care Information Technology center recommends amoxicillin-clavulanate, azithromycin, trimethoprim/sulfamethoxazole, or TMP/SMX, and cefuroxime to treat mild Haemophilus influenzae infections. Ampicillin and amoxicillin should be used only if the laboratory tests confirm their effectiveness. More severe Haemophilus influenzae infections such as those of brain, bloodstream, lungs and bone, require intravenous administration of the third-generation cephalosporins, ceftriaxone and cefotaxime or ciprofloxacin, for 10 to 14 days. Common side effects of most of these antibiotics include nausea, vomiting and diarrhea. TMP/SMX can induce the rare condition known as Stevens-Johnson syndrome which is characterized by red or purplish skin rash that spreads and blisters, eventually causing the top layer of the skin to die.
University of Maryland Medical Center suggests that the use of fluoroquinolone and cephalosporins, in combination with macrolides such as azithromycin or erythromycin, are also useful to treat respiratory tract infections caused by Haemophilus influenzae. Low doses of oral rifampin are prescribed to unvaccinated individuals who have been exposed to Haemophilus influenzae to prevent infection. Rifampin can increase the metabolism of oral contraceptives, however, and can turn tears and urine orange/red and thus, should be used with caution.
Anti-pyretics
Haemophilus influenzae infections are often associated with fever. Anti-pyretics, or fever reducers, such as acetaminophen, ibuprofen or aspirin may be given orally in case of mild infections and intravenously in case of severe infections. The University of Maryland Medical Center, however, warns against the use of aspirin in children younger than 18 years of age due to the risk of developing a serious condition called Reye's syndrome that can affect the brain and the liver.
Oxygen Therapy
Oxygen therapy is often given to patients with Haemophilus influenzae infections of lungs and the bloodstream that cause shortness of breath and disorientation. Such patients are usually hospitalized and given oxygen in concentrations higher than that in the room environment using a simple face mask or a nasal cannula.
Intravenous Fluids
Haemophilus influenzae infections of the bloodstream can lead to low blood pressure and shock. Intravenous fluids such as saline, which consists of 0.9 percent sodium chloride, are given to such patients using an intravenous drip and an access device such as a hypodermic needle or a peripheral cannula.
Corticosteroids
Infections of the brain, also known as meningitis, caused by Haemophilus influenzae can lead to hearing loss, especially, in young children. In an article published in December 2007 edition of the "New England Journal of Medicine," Dr. Brian M. Greenwood recommends administration of corticosteroids to children with acute Haemophilus influenzae type B meningitis before the start of antibiotic therapy to reduce the incidence of complications such as deafness.
References
- World Health Organization: Haemophilus influenzae type b
- Johns Hopkins Point of Care Information Technology Center: Haemophilus influenzae
- University of Maryland Medical Center: Pneumonia Treatment
- "The New England Journal of Medicine"; Corticosteroids for Acute Bacterial Meningitis; Brian M. Greenwood; December 2007
