Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The tetracyclines are effective in the treatment of Chlamydia, Mycoplasma pneumoniae, and rickettsial infections and may also be used for gonococcal infections in patients unable to tolerate penicillins. These drugs may cause gastrointestinal irritation, photo-toxic dermatitis, diarrhea, vestibular damage, and hepatotoxicity in pregnant women. Chloramphenicol is used primarily for anaerobic infections, Haemophilus influenzae meningitis, and typhoid fever. The most important toxic effect of chloramphenicol is bone marrow suppression, which can be dose related or idiosyncratic. Erythromycin is the drug of choice for the treatment of infections caused by M. pneumoniae, Legionella species, group A beta-hemolytic streptococci, and Streptococcus pneumoniae. The frequency of serious untoward effects associated with the use of erythromycin is low; epigastric distress may occur. Clindamycin is active against Bacteroides fragilis and other anaerobic microorganisms. Pseudomembranous enterocolitis has developed in as many as 10% of patients taking this drug. The use of clindamycin should be discontinued promptly if diarrhea occurs.
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PMID:Tetracyclines, chloramphenicol, erythromycin, and clindamycin. 365 8

A total of 432 clinical isolates of Staphylococcus aureus (128), coagulase-negative staphylococci (123), group A and B beta-hemolytic streptococci (61), group D streptococci (30), Streptococcus penumoniae (29), Haemophilus influenzae (19), Haemophilus parainfluenzae (12), and Legionella pneumophila (30) were examined with the agar dilution and Bauer-Kirby agar disk diffusion tests for susceptibility to josamycin as compared with erythromycin. On a weight-for-weight basis, erythromycin was more active than josamycin against all bacterial species, including L. pneumophila. Josamycin inhibited 18 of 23 S. aureus and 11 of 16 coagulase-negative staphylococcal strains resistant to erythromycin. Utilizing minimal inhibitory concentrations (MIC) breakpoints of less than or equal to 2 micrograms/ml (sensitive), 4 microgram/ml (intermediate) and of greater than or equal to 8 micrograms/ml (resistant), and inhibition zone criteria of greater than or equal to 18 mm diameter (sensitive), 14-17 mm (intermediate), and less than or equal to 13 mm (resistant), and excluding L. pneumophila, there was good correlation between erythromycin MIC and corresponding disk diffusion data for staphylococci and streptococci, but not for Haemophilus species. In comparison, josamycin yielded a significant number of minor discrepant data for group D streptococci and Haemophilus species. It is suggested that erythromycin and josamycin should not be tested against Haemophilus species, and that josamycin should be excluded from test batteries against enterococci. Erythromycin-resistant staphylococci require separate testing with josamycin.
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PMID:Josamycin: interpretation of inhibition zones with the Bauer-Kirby agar disk diffusion test as compared with erythromycin. 373 19

Erythromycin, first introduced for clinical use 30 years ago, was found to be effective for the treatment of gram-positive bacterial infections. Emergence of resistance and the advent of penicillinase-resistant penicillins limited the use of erythromycin for serious staphylococcal infections; however, erythromycin remains among the drugs of choice for the treatment of acne, infections of the skin and soft tissues, streptococcal pharyngitis, bronchitis, pneumonitis, diphtheria, carriers of pertussis, and, when administered with a sulfonamide, otitis media. Erythromycin is the drug of choice for the empiric treatment of outpatients with pneumonitis. Erythromycin is also the drug of choice for the treatment of Legionella pneumonia and is effective therapy for Chlamydia infections. Other uses of erythromycin include prophylaxis for elective colon operations and treatment of Campylobacter enteritis, genitourinary infections, and some sexually transmitted diseases.
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PMID:Erythromycin: a microbial and clinical perspective after 30 years of clinical use (2). 388 13

Erythromycin is a macrolide that acts by inhibiting the translocation reaction during protein synthesis. Erythromycin is inactive against the Enterobacteriaceae and Pseudomonas aeruginosa except under alkaline conditions. Erythromycin is active against most gram-positive bacteria; some gram-negative bacteria, including Neisseria, Bordetella, Brucella, Campylobacter, and Legionella; and Treponema, Chlamydia, and Mycoplasma. The emergence of resistance to erythromycin is closely associated with its use and is often plasmid mediated. After its oral or parenteral administration, erythromycin diffuses readily into intracellular fluids and is actively concentrated intracellularly by polymorphonuclear leukocytes and alveolar macrophages.
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PMID:Erythromycin: a microbial and clinical perspective after 30 years of clinical use (1). 397 1

Erythromycin-resistant Legionella spp. variants were obtained by a single passage of the naturally occurring bacteria on medium containing various concentrations of erythromycin. By disk diffusion susceptibility testing, at least three different phenotypic patterns of cross-resistance to macrolide, lincosamide, and streptogramin B antibiotics were observed among the 26 erythromycin-resistant strains examined.
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PMID:Isolation and preliminary characterization of erythromycin-resistant variants of Legionella micdadei and Legionella pneumophila. 398 5

The in vivo antimicrobial effect of seven new beta-lactamase-resistant cephems (cefotaxime, latamoxef, ceftazidime, ceftriaxone, cefotiam, cefbuperazone, and MT-141) on Legionella pneumophila (strain 81-066, serogroup IV) in guinea pigs was compared with that of erythromycin. As the minimal LD100 within one week was about 4.0 X 10(9) CFU/ml by intraperitoneal injection of the strain, the animals were inoculated with 2.0 ml of twofold dilutions of a suspension of this bacterium. The animals developed purulent peritonitis and systemic involvement demonstrated by the development of periangitis, pneumonia and pleuritis in the lungs. Three different doses of antibiotics were administered intraperitoneally immediately after the rectal temperature reached more than 40 C. Erythromycin had a significant therapeutic effect but none of the new cephems tested death of the infected guinea pigs.
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PMID:New beta-lactamase-resistant cephem treatment of guinea pigs infected with Legionella pneumophila. 631 15

A guinea pig model of Legionnaires' disease was produced by intratracheal inoculation of Legionella pneumophila. The bacterial inoculum given reproducibly resulted in a 95% fatality rate in untreated animals. These animals had lung histopathologic and bacteriologic findings almost identical to those found in human Legionnaires' disease. Administration of cefoxitin and gentamicin, which inhibited the infecting strain in low antibiotic concentration in vitro, was no more effective than saline; this occurred despite adequate serum and lung levels of the drugs. Erythromycin, rifampin, doxycycline, and cotrimoxazole significantly reduced fatality rates. The combinations of erythromycin with rifampin and doxycycline with rifampin were not significantly better or worse than use of either drug alone. In animals treated with any regimen containing rifampin, a dramatically higher rate of bacterial killing was observed than that observed in those animals treated with erythromycin or doxycycline alone. Also, animals treated with any regimen containing rifampin had significantly less late lung histologic evidence of pneumonia than did those treated with other agents. No rifampin-induced resistance was found. This animal model reflects prior clinical findings, provides experimental grounds for therapy with drugs other than erythromycin, and suggests that therapy of Legionnaires' disease should probably include rifampin in most cases.
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PMID:Antimicrobial therapy of experimentally induced Legionnaires' disease in guinea pigs. 633 40

Nosocomial pneumonia caused by Legionella pneumophila serogroup 1 occurred in five patients after bone marrow transplantation for hematologic malignancies. Two patients died as a result of the infection despite treatment with erythromycin. Serologic screening revealed no other cases of Legionnaires' disease in 40 consecutive recipients of bone marrow transplants, giving a frequency of infection of 13 percent. These five cases represent 23 percent of the pneumonia occurring in this group of patients. Patients undergoing bone marrow transplantation are highly susceptible to infectious complications. Legionnaires' disease must now be added to the list of pathogens infecting this group of patients. Erythromycin is not generally a part of standard empiric antibiotic regimens in febrile neutropenic patients, but appears to be a reasonable addition when pneumonia does not respond to conventional, empiric treatment. Even with appropriate therapy, Legionnaires' disease remains a highly lethal infection in immunocompromised hosts.
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PMID:Nosocomial Legionnaires' disease. Occurrence in recipients of bone marrow transplants. 633 88

The genus Legionella, belonging to the family of Legionellaceae, comprises nowadays seven species, among which Legionella pneumophila might be the most important. The identification of the agent is difficult because L. pneumophila is very pretentious requiring peculiar conditions concerning culture medium, temperature, and time. The initial cultivation will succeed the best in an atmosphere enriched with CO2. The demonstration of serum antibodies will succeed by means of indirect immunofluorescence; recently the micro-agglutination test is vastly applied. The clinical picture of Legionellosis is characterized by an atypical pneumonia with a serious course in most cases. The Pontiac Fever is an illness with milder course than the classical form of Legionellosis. Erythromycin and Rifampicin are the chemotherapeutics of choice.
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PMID:[The detection of the agent of Legionnaires' disease--a confirmation of Koch's postulates]. 635 47

A 46-year-old man showed a clinical response when treated with parenteral erythromycin for what was initially thought to be legionnaires' disease, but an organism isolated from his pleural fluid on CYE agar was subsequently identified as Francisella tularensis. Tularemia should be suspected in all cases of atypical pneumonia in the appropriate setting. Erythromycin may be effective empiric therapy in such cases. Because of the possibility of inadvertent isolation of Francisella tularensis on CYE agar, all cultures for suspected Legionella should be handled with extreme caution, preferably in a biological hood.
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PMID:Tularemia pneumonia mimicking legionnaires' disease: isolation of organism on CYE agar and successful treatment with erythromycin. 661 98


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