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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The response of Legionella pneumophila to antibiotics that inhibit cell-wall, protein and DNA synthesis was examined by electronmicroscopy, MIC estimations and viable counts. Ampicillin, cefotaxime, methicillin, erythromycin, rifampicin and ciprofloxacin, each used separately at 20 times their respective MIC values, showed activity against L. pneumophila in these studies. The inhibitors of cell-wall synthesis--ampicillin, cefotaxime and methicillin--effected the greatest bactericidal activity and induced the most extensive morphological changes, which included the formation of membranous lesions through which cytoplasmic contents were lost. In terms of ultrastructural damage and loss of viability, the inhibitors of protein and DNA synthesis were less effective than the antibiotics that acted on the microbial cell wall. Erythromycin- and rifampicin-treated cells possessed irregular membranes and were partially or fully lysed, whereas ciprofloxacin induced abnormally elongated organisms with intermittently lysed and detached inner membranes. These results illustrated the ability of antibiotics of putative clinical value, with diverse modes of action, to affect the ultrastructural cytology as well as the viability of L. pneumophila in vitro.
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PMID:The effect of antibiotics that inhibit cell-wall, protein, and DNA synthesis on the growth and morphology of Legionella pneumophila. 229 40

Erythromycin and related macrolide antibiotics have recently enjoyed a resurgence of clinical interest. This is a result of activity against organisms which are becoming more prevalent, particularly in immunocompromised hosts and, in addition, better understanding of the unique tissue penetration properties and potential immunomodulating properties of macrolides. Other features of clinical interest possessed by certain of the newer macrolides include the potential for once-daily dosing, resistance to acid degradation in the stomach without enteric coating, and possibly reduced gastrointestinal side effects. The new macrolides are expected to retain the clinical indications of erythromycin, which include upper and lower respiratory tract infections, skin and skin structure infections, and genital tract infections caused by erythromycin-susceptible organisms. In addition, enhanced activity has been demonstrated in animal models and in vitro against toxoplasma, Legionella, Haemophilus, and Campylobacter spp. New macrolide derivatives also show promise to expand the antimicrobial spectrum of erythromycin to include Mycobacterium and Borrelia spp.
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PMID:New directions for macrolide antibiotics: pharmacokinetics and clinical efficacy. 268 5

A 42-yr-old woman with long-standing ulcerative colitis of the descending colon, sigmoid, and rectum presented with bloody diarrhea, tenesmus, and high fever. Endoscopic findings were compatible with an acute attack of ulcerative colitis, which proved to be resistant to systemic corticosteroid treatment. In the presence of an acute abdomen with ascites and double-contoured colonic wall, hemicolectomy was performed. Postoperatively, high temperature, hyponatremia, and elevated liver enzyme levels persisted. Pleural effusions developed. Antibodies to Legionella pneumophila serogroup 3 were detected in the serum. Erythromycin therapy induced rapid improvement. In a massive submucosal edema of the affected colon, L. pneumophila of the same serogroup was demonstrated by direct immunofluorescence staining.
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PMID:Legionella infection of the colon presenting as acute attack of ulcerative colitis. 231 72

The in vitro activity of azithromycin (CP 62,993 or XZ-450) against Haemophilus influenzae was greater than that of three other macrolides. However, azithromycin was four- to eightfold less active than erythromycin against the gram-positive cocci and against Listeria monocytogenes. Erythromycin and azithromycin were similar in their activity against Legionella pneumophila, Neisseria gonorrhoeae, Neisseria meningitidis, and Branhamella catarrhalis.
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PMID:In vitro activities of azithromycin (CP 62,993), clarithromycin (A-56268; TE-031), erythromycin, roxithromycin, and clindamycin. 284 16

Pneumonia is an important cause of morbidity and mortality. A variety of conditions that damage the airways and weaken host defense mechanisms increase the susceptibility of the individual to bacterial colonization of the pulmonary tree. Because the clinician frequently cannot determine the etiologic agent, pneumonia is often treated empirically. Cefonicid, a long-acting cephalosporin, is a useful and cost-effective antibiotic that is active against many of the common pathogens that cause community-acquired pneumonia, such as Streptococcus pneumoniae and Haemophilus influenzae. It is also active against less common community-acquired pathogens, such as Klebsiella pneumoniae, Escherichia coli, and some anaerobic mouth flora. Erythromycin is useful when Mycoplasma or Legionella species are suspected. Cefonicid's demonstrated safety and efficacy, its low cost, and its long half-life, permitting once-daily dosing, make this antibiotic an ideal parenteral choice for empiric therapy of community-acquired pneumonia.
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PMID:Community-acquired pneumonia: etiology, diagnosis, and treatment. 285 99

A-56268 is a new macrolide antibiotic that resembles erythromycin in its spectrum of activity. A-56268 and erythromycin had identical activities against Streptococcus pyogenes, group B, C, and G streptococci, and viridans group streptococci. Erythromycin and A-56268 had similar activities against Staphylococcus aureus, coagulase-negative staphylococci, and group D enterococci. Like erythromycin, A-56268 was ineffective in inhibiting oxacillin-resistant S. aureus, oxacillin-resistant, coagulase-negative staphylococci, and penicillin-resistant viridans group streptococci. Haemophilus influenzae, Neisseria gonorrhoeae, and Legionella spp. were inhibited by A-56268 at concentrations similar to those of erythromycin.
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PMID:In vitro activity of A-56268 (TE-031), a new macrolide antibiotic, compared with that of erythromycin and other antimicrobial agents. 295 42

Ofloxacin was evaluated as an antibiotic for possible use in the therapy of Legionnaires' disease in relation to its ability to penetrate alveolar phagocytes and inhibit Legionella pneumophila intracellular replication. A comparison with two other antibiotics used in the treatment of Legionnaires' disease, ciprofloxacin and erythromycin, was also made. Ofloxacin was found to be the most effective antibiotic, eliminating viable L. pneumophila from alveolar phagocytes at 0.001 mg/l. This was followed by ciprofloxacin, eliminating intracellular organisms at 0.01 mg/l. Erythromycin was shown to be much less effective, requiring a much higher concentration, of 0.1 mg/l. All three antibiotics had approximately similar MIC values and the considerable differences in intracellular penetration shown by these antibiotics indicate how discrepancies between in-vitro and in-vivo estimates of efficacy can occur.
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PMID:The effect of ofloxacin on the intracellular growth of Legionella pneumophila in guinea pig alveolar phagocytes. 318 62

Of the Legionellaceae family, Pittsburgh pneumonia agent (Tatlockia micdadei, Legionella micdadei) is second only to Legionella pneumophila in causing human pneumonia. In nosocomial infection, the patients tend to be immunosuppressed. The clinical presentation is nonspecific, although in immunosuppressed hosts the presentation may mimic that of pulmonary embolus (pleuritic chest pain, nonproductive cough, pleural-based densities on chest rontgenogram). The reservoir for the organism is water, and prevention of nosocomial infections can be accomplished by disinfection of the water supply. Diagnosis is best established by isolation of the organism from respiratory secretions by using selective, dye-containing buffered charcoal-yeast extract agar. The organisms can be acid-fast when clinical specimens are stained. Erythromycin is the antibiotic of choice, although tetracyclines, trimethoprim-sulfamethoxazole, and rifampin have also proved to be efficacious.
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PMID:Infections caused by the Pittsburgh pneumonia agent. 332 96

In 1979, an isolated case of legionnaires' disease in a 46 year old Caucasian male Ohio physician was reported. Diagnosis was later confirmed by a fourfold increase in indirect immunofluorescent antibody titer level. Recovery began rapidly after the administration of erythromycin therapy and appeared to be complete. The following year the same patient suffered an apparent reinfection, once again realizing prompt and total recovery upon receiving erythromycin therapy. Although not commonly reported, the possibility of reinfection with the Legionella bacterium is a reality. The source of human innoculation need not necessarily be a common water supply or large cooling system reservoir (as was previously thought). Erythromycin continues to be widely regarded as the treatment of choice for infections with the Legionella bacterium even though this case demonstrates that it does not prevent reinfection.
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PMID:Recurrent Legionnaires' disease: a case report. 345 13

Cyclosporine (CsA), an immunosuppressive drug widely used in clinical organ transplantation, causes a variety of side effects, including parenchymal complications of nephrotoxicity and hepatotoxicity. Erythromycin ethinylsuccinate (EES), a macrolide antibiotic frequently administered to transplant patients afflicted with pneumonias caused by Mycoplasma pneumoniae and Legionella pneumophila, markedly potentiated parenchymal drug toxicity in nine (three renal and six cardiac) CsA-treated allograft recipients. The mean and median blood urea nitrogen (BUN), creatinine, and total bilirubin increased upon initiation of EES treatment: in the renal recipients from 27, 1.7, and 0.5 mg/dl, respectively, before, to a mean and median of 81/101, 8.3/3.9, and 2.1/1.2 mg/dl during, and to 72/22, 1.9/1.7, and 0.6/0.5 mg/dl after cessation of EES treatment. The median serum radioimmunoassay (RIA)-determined CsA trough value of 147 ng/ml prior, rose to a zenith of 1125 ng/ml during, EES therapy. In the six cardiac recipients, the mean and median BUN, creatinine, and total bilirubin of 51/45, 1.5/1.3, 1.2/1.3 mg/dl, respectively, before, rose to 100/91, 3.7/3.6, and 2.3/2.1 mg/dl during, and fell to 49/44, 1.8/2.1, and 1.0/0.8 mg/dl after, cessation of EES. The mean serum CsA trough value of 185 ng/ml rose to 815 ng/ml during EES administration. Since EES and CsA are both metabolized by the hepatic cytochrome P450 mixed-function oxidase system, simultaneous use of these two drugs may decrease CsA metabolism, with consequent elevation of blood levels and induction of CsA toxicity. Therefore, blood level monitoring and careful regulation of CsA dose are necessary, in order to achieve the safe use of EES in transplant recipients.
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PMID:Exacerbation of cyclosporine toxicity by concomitant administration of erythromycin. 354 86


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