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

Respiratory infections place a heavy burden on patients, providers, employers, and health care systems. The prescribing of antibiotics is common, despite the fact that many respiratory conditions are caused by viruses. The economic effect of treating respiratory tract infections with broad-spectrum antibiotics was retrospectively analyzed by means of health care claims data from six managed care health plans affiliated with a large national insurer. A regression model was used to adjust for factors that can influence treatment costs, such as age, baseline cost, retreatment, and drug cost. The costs of treating chronic bronchitis, pneumonia, and acute sinusitis with moxifloxacin, gatifloxacin and nonfluoroquinolone broad-spectrum agents were significantly lower than the costs associated with levofloxacin treatment.
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PMID:Costs of broad-spectrum antibiotic use for acute sinusitis, chronic bronchitis, and pneumonia in a managed care population. 1284 Oct 74

Pneumococcal vaccine Pneumo-23, used for specific prophylaxis of pneumonia and other pneumococcal infections, was tested in military training units of the North Western, Central and Far Eastern Military Districts. The vaccine used for immunization of servicemen, was shown to have high immunogenicity with no adverse reactions. In the training group of the North Western Military District the epidemiological effectiveness of the vaccine was particularly high a month after immunization and amounted to 83.7%. During the period between month 2 and month 5 after immunization pneumonia morbidity among the immunized servicemen was 6.12 times lower than among the non-immunized ones. In the training units of the Central and Far Eastern Military Districts, where the period of the formation of postvaccinal immunity coincided with the peak of the outbreak of pneumonia, the protective properties of the used batches of the vaccine could be observed as early as during the first month after immunization, which made it possible to recommend this vaccine for urgent prophylaxis in the foci of pneumococcal infection. During the period of 5 months the effectiveness of the vaccine with respect to pneumonia was 62.1-66.2% for all three districts. The effectiveness of the combined immunization of conscripts with vaccines Pneumo-23 and Vaxigrip with respect to pneumonia was higher (78.54%) and the index of effectiveness (4.66) was 1.58 fold greater than in monoimmunization (2.95). The epidemiological effectiveness of the pneumococcal vaccine was high also with respect to other pneumococcal infections: acute bronchitis, acute respiratory diseases of pneumococcal etiology, cases of acute sinusitis and acute otitis. The use of the vaccine for the immunization of servicemen yielded the economic effect equal to 92 US dollars per person.
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PMID:[Efficacy of pneumococcal vaccine in military units]. 1288 5

Telithromycin is the first ketolide antibacterial to be approved for clinical use. The ketolides represent a novel class of antibacterial agents structurally related to the macrolides, which has been developed specifically to offer an optimal spectrum for the treatment of upper and lower respiratory tract infections (RTIs) caused by common and atypical pathogens, including strains that are resistant to currently used antibiotics. The innovative structural changes that distinguish telithromycin from macrolides contribute to its unique microbiological profile. Its well-balanced spectrum of antibacterial activity is highly appropriate for the empirical treatment of upper and lower community-acquired RTIs, offering activity against common, including resistant, and atypical/intracellular pathogens. Furthermore, telithromycin demonstrates a low propensity to select for or induce resistance to macrolide-lincosamide-streptogramin antibacterials. A once-daily dose of telithromycin 800 mg rapidly achieves high concentrations in both plasma and respiratory tissues and fluids and is maintained at effective levels throughout the 24-hour dosing period. In clinical trials, telithromycin has demonstrated high clinical and bacteriological efficacy in the treatment of community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute sinusitis and group A beta-haemolytic streptococcal tonsillitis/pharyngitis. High efficacy was maintained in those patient groups considered to be at high risk of complications and those with infections caused by penicillin and/or macrolide (erythromycin) resistant Streptococcus pneumoniae. Together with its favourable tolerability profile and short course of once-daily therapy, these properties indicate that telithromycin will be a valuable new antibacterial for the empirical treatment of community-acquired RTIs.
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PMID:Telithromycin: the first ketolide antibacterial for the treatment of community-acquired respiratory tract infections. 1291 92

A pooled analysis of data from 13 phase III studies of telithromycin in the treatment of community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute sinusitis or group A beta-haemolytic streptococcal pharyngitis and tonsillitis was undertaken. Causative key respiratory tract pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes) were isolated at entry to the studies from cultures of relevant respiratory samples and tested for their susceptibility to telithromycin, penicillin and macrolides (erythromycin A). The combined clinical and bacteriological efficacy of telithromycin at the post-therapy, test-of-cure visit (days 17-24) was assessed in patients from whom a microbiologically evaluable pathogen was isolated at entry. More than 98% of key respiratory pathogens isolated, including penicillin G- and macrolide (erythromycin A)-resistant strains of S. pneumoniae, demonstrated full or intermediate susceptibility to telithromycin in vitro at the breakpoints of < or = 1.0 mg/L (susceptible) and 2.0 mg/L (intermediate) used for the purpose of evaluating the susceptibility of isolates recovered during the clinical trials. Treatment with telithromycin 800 mg once-daily for 5, 7 or 7-10 days resulted in high rates of clinical cure (88.5%) and a satisfactory bacteriological outcome (88.9%), similar to the figures seen with comparator antibacterial agents. Clinical cure and eradication rates were good for all key respiratory pathogens, including penicillin G- and macrolide (erythromycin A)-resistant S. pneumoniae. The results suggest that telithromycin will provide effective empirical therapy for community-acquired upper and lower respiratory tract infections.
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PMID:Clinical and bacteriological efficacy of the ketolide telithromycin against isolates of key respiratory pathogens: a pooled analysis of phase III studies. 1470 83

Moxifloxacin (Avelox - Bayer plc), the latest fluoroquinolone antibacterial to be launched in the UK, is licensed for the oral treatment of adults with community-acquired pneumonia, acute exacerbation of chronic bronchitis or acute sinusitis. The company claims that the drug provides "rapid relief from chest infections". Here we review the place of moxifloxacin in treating patients with respiratory tract infections.
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PMID:Moxifloxacin--a new fluoroquinolone antibacterial. 1531 Jan 55

Levofloxacin is widely regarded as one of the most important fluoroquinolones available today. It possesses excellent activity against a wide range of important pathogens, including those resistant to many other antimicrobials. While rates of resistance to other previously useful antimicrobial classes has grown, levofloxacin has maintained its efficacy, with generally very low rates of resistance around the world. It is indicated for a wide range of infections including community-acquired respiratory infections in adults, particularly community-acquired pneumonia (CAP), acute bacterial exacerbations of chronic bronchitis (AECB), and acute sinusitis. In addition, it is recommended for infections of skin and soft tissue, and the urinary tract. With postmarketing surveillance data available for the last decade, levofloxacin possesses an unparalleled database to demonstrate its clinical efficacy and safety. Remarkably, levofloxacin continues to expand its list of indications. The development of a new high-dose 750-mg schedule has the potential to decrease the duration of treatment as well as reduce the emergence of resistance.
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PMID:New insights in the treatment by levofloxacin. 1531 51

Gatifloxacin (Tequin) is an 8-methoxy fluoroquinolone approved in the US for use in the treatment of community-acquired pneumonia (CAP), acute exacerbations of chronic bronchitis (AECB), acute sinusitis, uncomplicated and complicated urinary tract infections (UTIs), pyelonephritis, gonorrhoea and uncomplicated skin and skin structure infections. Gatifloxacin has a broad spectrum of antibacterial activity in vitro and good clinical and bacteriological efficacy in patients with indicated infections following once-daily administration by the intravenous or oral routes. It is generally well tolerated; the most common adverse events are associated with the gastrointestinal tract and CNS. Recent approvals for the use of gatifloxacin in the treatment of CAP due to multidrug-resistant Streptococcus pneumoniae (MDRSP) and in uncomplicated skin and skin structure infections extend the role of this drug in the treatment of bacterial infections in the US.
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PMID:Gatifloxacin: a review of its use in the treatment of bacterial infections in the US. 1574

Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by hypogammaglobulinemia and recurrent bacterial infections. The records of 65 patients with CVID (37 males and 28 females) in the age range of 24 to 537 months were reviewed. By the year 2003, 11 patients had died and seven patients could not be located. The total follow-up period was 221 patient-years. The median diagnostic delay (time between onset and diagnosis) in our patient group was 60 months. At the time of diagnosis, the baseline serum immunoglobulin G (IgG), IgM, and IgA levels were below the level normal for the patients' age; the medians for this group were 120, 10, and 0 mg/dl, respectively. All of the patients presented with infectious diseases at the time of onset, the most common of which were otitis media, diarrhea, pneumonia, and sinusitis. Acute and recurrent infections were also found in almost all of the patients, particularly involving respiratory and gastrointestinal systems. The most common infections, before diagnosis and during follow-up, were pneumonia, acute diarrhea, acute sinusitis, and otitis media. CVID should be considered in any patient with a history of recurrent infections and decreased levels of all serum immunoglobulin isotypes.
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PMID:Clinical and immunological features of 65 Iranian patients with common variable immunodeficiency. 1600 30

In this study, we investigated and analysed clinical efficacy and tolerability of moxifloxacin, a new quinolone antibiotic, for the outpatient treatment of bacterial respiratory infections--acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), pneumonia and acute sinusitis. The study was post-marketing and observational, and was conducted after the registration and listing of moxifloxacin in commercial distribution in Croatia. A total of 84 physicians throughout Croatia participated in this study that included 440 patients, 231 with clinically confirmed diagnosis of AE-COPD, 103 with pneumonia and 46 with acute sinusitis. According to physicians, evaluation, 96.8% of the patients were cured. The improvement was recorded on the average after 3.2 days and cure after 6.4 days from the beginning of treatment. Adverse events (48 side effects) were recorded in 40 patients, most commonly suffering from milder gastrointestinal symptoms (nausea, diarrhoea). Serious adverse events were not recorded (phototoxicity, severe hepatic impairment, cardiotoxicity). Moxifloxacin tolerability and patient compliance during treatment were rated as excellent in three-quarters of the patients. Physicians stated they would again prescribe moxifloxacin in 415 or 94.3% of the patients.
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PMID:[Efficacy of moxifloxacin in the treatment of respiratory tract infections: the Croatian post-marketing study]. 1619 58

Streptococcus pneumonia and Haemophilus influenzae account for more than 50% of bacterial acute sinusitis. Isolated sphenoid sinusitis is a rare disease with potentially devastating complications such as cranial nerve involvement, brain abscess, and meningitis. It occurs at an incidence of about 2.7% of all sinus infections. There have been no previous reported cases of unilateral sphenoid sinusitis presenting as septicaemia in an otherwise healthy young immunocompetent adult.
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PMID:An unusual presentation of sphenoid sinusitis with septicaemia in a healthy young adult. 1671 90


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