Methods: Nineteen different strains of Lactobacilli were inoculated in microtiter plates at pH of 4.5 to 6.5 and exposed to twofold dilutions of pantoprazole at a range of 2.5 mg/mL to 2.5 μg/mL. Bacterial growth was monitored, and the minimum inhibitory concentration (MIC) of the drug was determined for the strains most sensitive to pantoprazole.
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Results: In the unexposed (control) group, nine Lactobacilli strains were affected by pH changes from 6.5 to 4.5. In the group exposed to pantoprazole, 9 of the 19 Lactobacilli strains were found to have an MIC below 625 μg/mL, with L. plantarum 14917 being the most sensitive (MIC = 20 μg/mL). In some strains, such as L. salivarius 11741, Gram-staining revealed conformational changes in the bacteria when grown in the presence of pantoprazole.
Conclusion: Growth rates and morphology of oral Lactobacillus are affected by the pH of the environment. Pantoprazole at supraphysiologic doses further affects growth rates and conformation in some strains.
Significance: The balance of oral flora and upper digestive tract homeostasis may be affected by unexpected targets of PPI pharmacotherapy, with possible unanticipated consequences (Laryngoscope. 2008;118:599-604).
U. S. Practice Variations in the Treatment of Chronic Laryngopharyngeal Neuropathy
Objectives: To evaluate differences in evaluation and workup of laryngopharyngeal neuropathy in a population of general otolaryngologists and fellowship-trained laryngologists.
Methods: Members of the American Laryngological Association (ALA) and the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) were surveyed. A questionnaire was e-mailed or mailed to 179 members of the ALA and 900 members from the AAO-HNS.
Results: Among the general otolaryngologists, 44.6% reported being unfamiliar with laryngopharyngeal neuropathy compared to 0% from the ALA group (P < .0001). After accounting for the respondents unfamiliar with the condition, the general otolaryngologists reported being less comfortable in diagnosing laryngopharyngeal neuropathy and were more concerned about the over-diagnosis of LPR when compared with the ALA.
Conclusion: General otolaryngologists and fellowship-trained laryngologists have several differences in the knowledge, workup, and treatment of chronic laryngopharyngeal neuropathy. This may translate to unnecessary treatments and tests for affected patients and should be addressed with further education targeting general otolaryngologists (Laryngoscope. 2013;124:955-960).