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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infections with parasitic protozoa have always been problems for the developing world and are becoming of greater importance to the developed world in this age of easy international travel. The major human protozoal diseases are summarised with an emphasis on their presentation in normal hosts and in immunocompromised individuals and current US drug treatment recommendations are discussed. Present antiprotozoal regimens are based either on a pharmacokinetic rationale or on clinical trial and error. Regimens based on trial and error include amphotericin B against leishmaniasis and arsenic against African trypanosomiasis. Regimens which are to some extent driven by pharmacokinetic or biochemical considerations include paromomycin and metronidazole against amoebiasis, sodium stibogluconate against leishmaniasis, halofantrine and mefloquine against malaria, dihydrofolate reductase (DHFR) inhibitors against Pneumocystis carinii and toxoplasmosis and aerosolised pentamidine against P. carinii pneumonia. The majority of pharmacokinetic studies have been performed only on agents which have some therapeutic activity against other diseases of the developed world. Despite the trend toward rational treatment regimens, no studies have been performed that permit optimisation of antiprotozoal treatment regimens on the basis of clinical conditions such as renal failure.
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PMID:Pharmacokinetic justification of antiprotozoal therapy. A US perspective. 178 41

In a multicentre clinical trial involving 32 hospitals, 588 adult patients diagnosed with nosocomial pneumonia and not receiving mechanical ventilation were treated randomly with monotherapy with cefotaxime or the antibiotic combination routinely used in each particular hospital. Both groups of patients were similar regarding demographic data, concurrent diseases, additional therapies and causative organism. Protocol violations were recorded in 40 patients, and these patients were excluded from the evaluation of treatment efficacy. The cure rate was 79% in the cefotaxime group and 71% in the group receiving antibiotic combinations; this difference is statistically significant (p = 0.03, Fisher's two-tailed test). In the patients receiving combinations of cephalosporins having activity predominantly against gram-positive organisms plus aminoglycosides, the cure rate obtained was very low. The frequency of serious adverse reactions was significantly higher in the group treated with antibiotic combinations. It is concluded that monotherapy with cefotaxime is the regimen that offers better results for the empirical treatment of nosocomial pneumonia.
Infection 1991
PMID:Nosocomial pneumonia: comparative multicentre trial between monotherapy with cefotaxime and treatment with antibiotic combinations. 179 Oct 77

Infections by Chlamydia psittaci are found worldwide in many species of mammal, including man, and birds. Small ruminants are affected mainly with abortion in the later phase of gestation. Additionally pneumonia and lesions in other organs can be observed. Pathological and clinico-epidemiological aspects of the infection with C. psittaci in small ruminants are described and discussed. The description of a case of conjunctivitis acquired by one of the authors through contact with infectious material alerts to the significance of C. psittaci as an agent able to cause zoonotic infections.
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PMID:[Chlamydia infections in sheep and goats. With a reference to its significance as a zoonosis]. 179 63

In 1989 a survey was conducted in 800 medical departments of university hospitals and large to small teaching and non-teaching hospitals in the Federal Republic of Germany and West Berlin to gather information on the usage of antibiotics for the treatment of community-acquired pneumonia. A total of 288 (36%) questionnaires could be evaluated. In cases of non-life-threatening pneumonia, the therapy specified was mostly correct, although macrolides as the treatment of choice were stated only rarely (11%). However, patients with life-threatening pneumonia were most often (50%) treated with new beta-lactam antibiotics or beta-lactam antibiotics in combination with aminoglycosides (43%). Thus, atypical pathogens causing pneumonia were not covered by most therapeutic regimens.
Infection
PMID:Antibiotic usage in community-acquired pneumonia: results of a survey in 288 departments of internal medicine in German hospitals. 164 95

Lower respiratory tract infections (LRTI) are commonly classified as either bronchitis or pneumonia, and these infections are associated with an extremely high morbidity in the community, as well as a high mortality in those patients that require hospitalisation. Therefore, such infections place a huge burden, both economically and as a user of health services, on the entire health care system. The antibiotic treatment of community-acquired pneumonia caused by gram-negative organisms or staphylococci is controversial, and these organisms may cause one-third of the cases of community-acquired pneumonia. Nosocomial pneumonia is caused even more often by gram-negative bacteria, and as such the development of rational and effective antibiotic therapy to cover these organisms is very important.
Infection 1991
PMID:The scope of lower respiratory tract infection. 180 84

In order to determine the efficacy and safety of the new quinolone ofloxacin in the treatment of chronic lower respiratory disease, 674 patients (353 with chronic bronchitis, 212 with community-acquired pneumonia and 109 with hospital-acquired pneumonia) were treated with ofloxacin 200 mg twice a day. In total, 627 patients (93%) showed a satisfactory clinical response, and 47 patients (7%) had no change or deterioration. Neither severe side effects nor interactions between ofloxacin and coadministered theophylline were seen. This is important in patients suffering from chronic obstructive airways disease. The antibiotic spectrum of ofloxacin covers nearly all bacterial pathogens causing infectious respiratory disease; furthermore, ofloxacin reaches high concentrations in pulmonary secretions and tissue. Ofloxacin is a proven antibiotic substance useful in the treatment of lower respiratory tract infections.
Infection 1991
PMID:Ofloxacin in lower respiratory tract infections. 180 86

In this review of 159 pts with systemic lupus erythematosus (SLE) followed for 18 years, 78 pts had major infections (20/100 pt-years). Patients with infection had a higher incidence of proteinuria, central nervous system involvement, the use of methylprednisolone boluses and mortality rate. Infection was independent of the amount of steroids and immunosuppressor drugs used. Microorganisms were isolated in 77% of the cases, gram negative enterobacteria were the most common isolates. 30% of the pts had pulmonary infection; and 84% of the infections happened during steroid therapy. Immunosuppression was associated to repeated infections. The 19 pts with fatal infections had a higher frequency of pneumonia and septicemia, and received high doses of steroids (> or = 40 mg). No relation to immunosuppression was found in this group. In 26% opportunistic microorganisms were isolated in association to the use of high doses of steroids. Even if survival of SLE has improved in the last 40 years, infections are still an important cause of mortality, most of them related to aggressive steroid therapy.
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PMID:[Infections in systemic lupus erythematosus]. 184 4

Ninety infants less than 1 year of age with pneumonia and 43 control infants were investigated for viral and chlamydial infection with the use of culture and serology and for bacterial infection with the use of blood cultures, lung aspirates, antibody assays and antigen detection procedures. One or more potential pathogens were identified in 62 (69%) cases with pneumonia and in 12 (28%) controls. Infection by respiratory viruses was identified in 42 (49%) cases and in 8 (19%) controls. Respiratory syncytial virus was the commonest pathogen identified and was found in 32 cases (37%). Bacterial infections were also common, being found in 27 (30%) cases and 3 (7%) controls, and predominantly involved Streptococcus pneumoniae (20%) or Haemophilus influenzae (11%). Bacterial infections were associated with raised white blood cell counts and were identified more often by antigen detection procedures (68%) than by culture of blood or lung aspirates (34%) or by serology (33%). Mixed viral-bacterial infections were identified in 13 cases (15%). Infection with Chlamydia trachomatis was diagnosed in 2 infants with acute lower respiratory tract infection and in 1 control infant.
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PMID:Etiology of acute lower respiratory tract infections in Gambian children: I. Acute lower respiratory tract infections in infants presenting at the hospital. 184 64

In a multicentre non-randomized open prospective study, 124 patients hospitalized in medical infectious disease or intensive care units, with severe community and hospital-acquired bacterial infections were treated with 15 mg/kg body weight amikacin in a once-daily dose given as a 30 min iv infusion, combined with other antibiotics. Infections were bacteriologically proven in 101 patients. The clinical responses showed 83.1% primary success and 83.9% definitive cure predominantly in intensive care patients with hospital-acquired infections and pneumonia. Bacteriological eradication was achieved in 67.3%. Bacteria associated with true failures and colonizations were predominantly Pseudomonas, Acinetobacter and Staphylococcus spp. The risk of nephrotoxicity may be decreased with such a regimen of amikacin, but no conclusions could be drawn with regard to ototoxicity. In summary, a once-daily dosing regimen of amikacin 15 mg/kg is practical and probably efficacious and safe in severely infected patients.
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PMID:Clinical and bacteriological efficacy, and practical aspects of amikacin given once daily for severe infections. 185 49

From Jan. 1, 1988, through Dec. 31, 1988, a total of 89 cases of measles were observed at Childrens Hospital of Los Angeles, and 37 patients were admitted to the hospital. Of the 37 patients, six were not initially thought to have measles, which resulted in exposure of 107 patients and 24 personnel. Of the exposed patients, measles developed in four. One nosocomially infected infant died of pneumonia. Another exposed patient was subsequently admitted to another hospital with unrecognized measles, which led to exposure of an additional eight patients. Of seven employees in whom measles developed, two required hospitalization because of pneumonia. Two hundred eleven employee days were lost because of measles exposure or infection. Infection control interventions included prophylaxis of exposed patients, employee education, and measles immunization for susceptible personnel. Of 1103 hospital personnel considered susceptible to measles, 800 received monovalent measles vaccine. No secondary cases of measles occurred in hospital personnel who received appropriate prophylaxis. We conclude that infection control programs aimed at mandating measles immunity in hospital employees at risk should be instituted.
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PMID:Nosocomial measles infection in a pediatric hospital during a community-wide epidemic. 186 Dec 4


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