Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy and tolerance of clarithromycin (250 mg twice daily) were compared with those of roxithromycin (150 mg twice daily) in an open, multicentre trial of 77 inpatients with community-acquired pneumonia. Sixty-five patients were clinically evaluable (34, clarithromycin; 31 roxithromycin). Efficacy was comparable between treatment groups: 26 of 34 patients (76%) treated with clarithromycin were clinically cured, including four with atypical pneumonia. In the roxithromycin group 25 of 31 patients (81%) were clinically cured and one was improved. Cough, appearance of sputum, and fever improved in most patients in both treatment groups. Chest X-rays after treatment showed resolution or improvement in 76% of patients who received clarithromycin and 87% of those who received roxithromycin. The clinical evaluation of the response generally agreed with the bacteriological response. Among patients who were bacteriologically evaluable for four target organisms (Streptococcus pneumoniae, Haemophilus influenzae, H. parainfluenzae, and Branhamella catarrhalis) the pathogen was eradicated in four of seven (57%) in the clarithromycin-treated group and in five of six (83%) in the roxithromycin-treated group. Adverse events were reported in more patients who received roxithromycin (21.6%) than in those who received clarithromycin (12.5%) although the incidences were not statistically significantly different. The majority of adverse events were transient increases in serum alanine aminotransferase, serum aspartate aminotransferase, and alkaline phosphatase. Clarithromycin was shown to be effective and well-tolerated; the clinical efficacy and safety of clarithromycin and roxithromycin were comparable.
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PMID:Comparative study of clarithromycin and roxithromycin in the treatment of community-acquired pneumonia. 182 96

Theophylline toxicity has been recognized since its introduction into clinical medicine. Clarithromycin is a new oral macrolide antibiotic with excellent antibacterial activity and rare adverse effect. Patients with upper respiratory infection are often treated with theophylline and clarithromycin concurrently. We report a case of acute renal failure due to acute rhabdomyolysis caused by the interaction of theophylline and clarithromycin. A 72-year-old man visited our hospital because of coughing and a sore throat continuing for 1 week. He was diagnosed as having the common cold with a bronchial asthmatic symptom and was prescribed 200 mg/day of sustained-release theophylline for the treatment of asthma for 7 days. One week later, he visited our hospital again. Radiographic study of the chest revealed mild interstitial pneumonia and 200 mg/day of sustained-release theophylline and 400 mg/day of clarithromycin were administrated concomitantly. Five days after the second visit, the patient was admitted to our hospital because of generalized twitching, muscular weakness, high fever and serious general condition. He experienced generalized muscular twitching and tremor. Blood urea nitrogen was 106.1 mg/dl, serum creatinine was 7.4 mg/dl, serum creatinine kinase (CK) was 36,000 IU/l (normal 15-130 IU/l), CK isozyme revealed the following ratio: BB 0%, MB 1% and MM 99%. He was diagnosed as having acute renal failure with rhabdomyolysis caused by the interaction of theophylline and clarithromycin. Hemodialysis therapy was started. After 5 weeks, his serum creatinine was markedly decreased. It is well-known that clarithromycin enhances the serum concentration of theophylline by inhibition of the cytochrome P450-dependent pathway in hepatocytes. Theophylline toxicity may be enhanced when clarithromycin is administrated concomitantly, especially to elderly patients with dehydration.
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PMID:[A case of acute renal failure with rhabdomyolysis caused by the interaction of theophylline and clarithromycin]. 1044 97

We present the case of bronchospastic reaction to clarithromycin had during a drug challenge test. Personal allergic history was negative for respiratory allergies and positive for adverse drug reactions to general and regional anesthesia and to ceftriaxone. After the administration of 1/4 of therapeutic dose of clarithromycin the patient showed dyspnea, cough and bronchospasm in all the lung fields. The positivity of the test was confirmed by the negativity to the administration of placebo. The quickness and the clinical characteristic of the adverse reaction suggest a pathogenic mechanism of immediate-type hypersensitivity. On reviewing the literature we have found no reports of bronchospastic reaction to clarithromycin. Macrolides are a class of antibiotics mainly used in the last years in place of beta-lactams because of a broad spectrum of action and a low allergic power. In fact, there are few reports on allergic reactions to these molecules. Clarithromycin is one of the latest macrolides, characterised by the presence of a 14-carbon-atom lactone ring as erythromycin, active on a wide spectrum of pathogens.
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PMID:Immediate reaction to clarithromycin. 1144 33

Nontuberculous mycobacteriosis due to M. smegmatis is a rarity. We report on the case of a 51 year old male HIV-seronegative patient without predisposing bronchopulmonary disease, but with a state after gastrectomy and splenectomy who developed unproductive cough, night sweat and weight loss. The chest radiograph and thoracic CT showed wide-spread bilateral patchy infiltrations. Histological examination of transbronchial biopsies revealed chronic carnificating pneumonia. A perhoracic fine-needle biopsy showed caseating epitheloid cell granulomas with acid fast bacilli. These were identified as M. smegmatis by PCR with subsequent sequencing. Acid fast bacilli could not be detected microscopically neither in sputum nor in bronchial secretions, however M. smegmatis has been repeatedly detected by culture in these materials. In neither material tubercle bacilli have been detected by nucleic acid amplification (NAT) or culture. Immunologic investigations revealed a reduced number of CD4+ lymphocytes and a reduction of interferon alpha- and -gamma-synthesis by peripheral blood mononuclear cells. Treatment with Rifabutin, Ethambutol, Clarithromycin and Ofloxacin resulted in complete clinical and roentgenological resolution.
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PMID:[Non-tubercular mycobacterial infection of the lungs due to Mycobacterium smegmatis]. 1144 9

This is the first clinical report of a case of pneumonia caused by Nocardia nova in Japan. A 52 year-old woman who had received steroids and cyclophosphamide for six years because of polymyositis was admitted to our hospital for further examination. On admission she had a mild cough, and her chest radiography and computed tomography revealed bilateral multiple nodules, some of which were cavitated. She developed a cough productive of yellow sputum and fever up to 38 degrees C. Examination of the sputum revealed a gram-positive branched organism and sputum cultures repeatedly grew Nocardia species. The isolate was identified as Nocardia nova later. Clinical recovery was obtained readily upon treatment with imipenem and trimethoprim methoxazole, though the latter drug was discontinued because of nausea and anorexia. This drug was therefore replaced with oral minocycline, which proved to be ineffective clinically although susceptibility testing of the drug showed positive sensitivity. Minocycline was replaced with clarithromycin, after which chest radiography and computed tomography showed almost total resolution of the infiltrates. Clarithromycin may be an alternative oral agent to sulfonamides or minocycline when these agents are ineffective or not tolerated.
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PMID:[Pneumonia caused by Nocardia nova]. 1157 29

A 52-year-old woman visited our hospital because of a cough and stridor in 1994. She had a history of non-tuberculous mycobacteriosis and chronic paranasal sinusitis. Her chest CT scan showed scattered centrilobular nodular shadows and peribronchial thickening, and so we suspected recurrent non-tuberculous mycobacteriosis or diffuse panbronchiolitis. Clarithromycin treatment was initiated, but she soon ceased taking the drug. She visited our hospital again because of a severe cough three and half years later. A new chest CT scan showed increased abnormal shadows, and so we suspected worsening non-tuberculous mycobacteriosis or diffuse panbronchiolitis. Consequently, we commenced treatment with rifampicin, ethambutol hydrochloride as well as clarithromycin. One year later, rheumatoid arthritis was diagnosed because of a swollen proximal interphalangeal joint in both fourth fingers. Her respiratory symptoms were not relieved with clarithromycin or antituberculous drugs, so a thoracoscopic biopsy was performed for a more accurate diagnosis. Histological examination revealed follicular bronchiolitis.
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PMID:[Follicular bronchiolitis preceding rheumatoid arthritis]. 1197 99

A 47-year-old man who suffered from fever and dry cough visited a local clinic. His symptoms temporarily improved with oral administration of ciprofloxacin, however, he was admitted to our hospital because of exacerbation. IgM antibody for Mycoplasma pneumoniae was positive and IgM antibody titer for Chlamydophila pneumoniae showed a high value of 7.12 index. Thus, coinfection was diagnosed. The findings of chest X-ray and computed tomography were compatible with atypical pneumonia. Clarithromycin improved his condition, and 10 weeks later, antibody values for Mycoplasma pneumoniae by the particle agglutination test decreased from 10,240 times to 640 times and those by the complement-fixation test also decreased from 1024 times to 256 times. The IgM antibody for Chlamydophila pnetumoniae decreased to 0.13. This is the first case developing coinfection with Mycoplasma pneumoniae and Chlamydophila pneumoniae in a middle-aged patient to date.
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PMID:[Coinfection with Mycoplasma pneumoniae and Chlamydophila pneumoniae in a middle-aged adult]. 1801 32

A 63-year-old man with a past history of resection of pulmonary adenocarcinoma and COPD visited our hospital because of fever, cough and purulent sputum. Chest CT showed an infiltration shadow with multiple bullae in the right lung. There was a slight elevation of the inflammatory response. We established a definitive diagnosis by frequent isolation of Mycobacterium kyorinense on a sputum culture test of acid-fast bacilli. Clarithromycin and levofloxacin were administered after identification of M. kyorinense using a 16S rRNA gene sequence. Subsequently his symptoms improved following combined therapy with clarithromycin and levofloxacin.
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PMID:Pulmonary Mycobacterium kyorinense disease showed clinical improvement following combined therapy with clarithromycin and levofloxacin. 2282 Nov 14

Brucellosis, a disease endemic in many countries including Turkey, is a systemic infectious disease. Brucellosis is rare in renal transplant recipients. Only 4 cases have been reported in the literature. In this report, we describe the clinical manifestations and laboratory findings of a brucellosis case with pulmonary involvement in a renal transplant recipient. A 20-year-old man who had a living-donor kidney transplant 4 months earlier presented to our transplant clinic with fever, cough, and right flank pain. Clarithromycin and ceftriaxone were started for the diagnosis of pneumonia. However, piperacillin/tazobactam, meropenem plus teicoplanin, and antituberculosis treatment were continued because the patient was unresponsive to the initial therapy. Serum Brucella agglutination titer was found to be 1/320. Treatment was started with a 6-week course of oral doxycycline and rifampin, resulting in cure. Brucellosis and especially its pulmonary involvement are rare after kidney transplant. However, in endemic areas,it should be considered as it mimics several other infectious diseases.
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PMID:Pulmonary Involvement in Brucellosis, a Rare Complication of Renal Transplant: Case Report and Brief Review. 2721 Feb 30