Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Penicillin--"tolerant" Staphylococcus aureus strains are resistant to the lethal action of penicillins, but are inhibited by normal (low) concentrations. They are deficient in autolytic enzyme activity which appears to be necessary for bacteriolysis and the lethal action of penicillins. This "deficiency" is caused by a large excess of an inhibitor of autolysin. Seven such tolerant strains have been isolated from blood, bone, or sputum of patients who responded poorly to penicillin treatment of endocarditis, osteomyelitis, or staphylococcal pneumonia. These isolates were of different phage-types, and most showed cross-tolerance to the killing action of cephalosporins or vancomycin, antibiotics to which they were sensitive (inhibited). They were killed at normal rates by gentamicin, cycloserine, and rifampicin. Population analysis indicated that the proportion of tolerant organisms within a resistant strain is 7% or less; their ability to inhibit autolytic activity within their own and neighbouring cells appears to account for the net decreased autolytic activity of the entire strain; 44% of the bacteraemic strains studied showed penicillin tolerance. Tolerance is thus a common, clinically important form of penicillin resistance, that differs from previously described forms of pencillin resistance, that due to beta-lactamase, and that due to "intrinsic" (e.g., methicillin resistance) mechanisms.
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PMID:A new type of penicillin resistance of Staphylococcus aureus. 6 61

Eikenella corrodens is a capnophilic gram-negative rod that is part of the normal human oral flora. We report the isolation of E. corrodens by transtracheal aspiration or percutaneous aspiration from 7 patients with pneumonia and/or lung abscess. Four of the 7 patients had an associated carcinoma of the lung. The susceptibilities of strains were tested to penicillin, dicloxacillin, clindamycin, and 10 cephalosporins. All strains were very susceptible to penicillin and cefoxitin and resistant to dicloxacillin and clindamycin. Susceptibilities of strains to the cephalosporins were variable. E. corrodens has been increasingly identified as a pathogen and should be recognized as an etiologic agent of pneumonia, especially in cases not responding to therapy with a penicillinase-resistant penicillin, clindamycin, or cephalosporin.
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PMID:Isolation of Eikenella corrodens from pulmonary infections. 36 16

Cefuroxime is a new parenteral antibiotic with a wider spectrum of activity than earlier cephalosporins and is particularly active against Haemophilus influenzae, including strains resistant to ampicillin due to beta-lactamase production. From 18 centres, 274 patients suffering with 275 infections were treated with cefuroxime sodium using the standard regimen of 750 mg 8-hourly by intramuscular injection. The clinical results showed a 90% success rate in the patients with bronchopneumonia (105), 91% in patients with post-operative pneumonia (74), and 89% in the patients with acute exacerbations of chronic bronchitis (96). Renal function was closely monitored during therapy, and no adverse changes attributable to cefuroxime therapy were seen in any patient, including those who also received frusemide. Two patients (0.7%) developed a rash, although 8 penicillin-allergic patients were treated without incident. From these studies, it can be concluded that 750 mg cefuroxime 8-hourly is effective in the treatment of lower respiratory tract infections. It is suggested that the attributes of this antibiotic may offer several advantages over existing therapies.
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PMID:Cefuroxime in the treatment of lower respiratory tract infection. 37 91

A prospective, randomized, single-blind comparison of parenteral cefamandole and ampicillin was conducted in 27 hospitalized adult patients with pneumonia or purulent tracheobronchitis due to Haemophilus spp. Patients received either parenteral cefamandole or ampicillin in a dose of 1 g every 6 h. Cefamandole was as effective and safe as ampicillin. Of the 14 patients treated with cefamandole, 13 were considered cured, as were 12 of the 13 treated with ampicillin. One patient in each treatment group improved clinically but did not clear his sputum of Haemophilus spp. One patient treated with cefamandole had a recurrence of Haemophilus spp. bronchitis 9 days after cure. Adverse effects were more common in the cefamandole-treated group (50% versus 15%), but were mild and did not require discontinuation of therapy in any patient. The in vitro susceptibilities of 64 clinical isolates of Haemophilus spp. to 10 antibiotics were determined. Cefamandole was the most active of the cephalosporin-cephamycin antibiotics tested, inhibiting 98% of 61 non-beta-lactamase-producing isolates at 2 mug/ml and 100% at 4 mug/ml. Cefamandole inhibited the three ampicillin-resistant isolates at 2 mug/ml or less. Cephapirin, cefoxitin, and cephalothin were the next most active, whereas cefazolin and cephradine were the least active.
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PMID:Clinical and laboratory evaluation of cefamandole in the therapy of Haemophilus spp. Bronchopulmonary infections. 38 11

Clinical and bacteriological efficacy, patient tolerance, and toxicity of cefoxitin, a beta-lactamase-resistant cephamycin, were evaluated in 38 patients; 13 had soft tissue infection, 12 had pneumonia, 3 had urinary tract infection, 2 had peritonitis, and 4 had miscellaneous infections. In five patients, infection was clinically evident, though not bacteriologically proven. The latter patients were evaluated with regard to tolerance and toxicity only. Among the 34 infections in 33 patients, 71% were considered clinically cured; 86% of those patients who could be recultured were bacteriologically cured. Phlebitis was noted in 32% of the total group, and eosinophilia was observed in 16%. Unexplained deterioration in renal function occurred in two patients. Mean peak cefoxitin levels in serum were 72 mug/ml 30 min after a 2-g infusion and 32 mug/ml 30 min after a 1-g infusion. Cefoxitin was more active against facultatively and obligately anaerobic gram-negative organisms isolated from these patients than was cephalothin.
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PMID:Cefoxitin: clinical evaluation in thirty-eight patients. 85 97

A prospective study of the efficacy of ampicillin in combination with sulbactam, a beta-lactamase inhibitor, (A/S) in perioperative prophylaxis was performed. The study consisted of two independent parts performed at the same time. Part I included 60 patients with lobectomies and segmentectomies. Group A (A/S 1 x 3 g "single shot") was compared with group B (A/S 3 x 3 g). Superficial wound infections occurred in 3 patients of group A and in 2 patients of group B. There was no empyema. Bronchitis and pneumonia were found in 10 patients of group A and in 7 patients of group B. Part II examined 25 pneumonectomies receiving A/S 3 x 3 g for 3 days. Concentrations of ampicillin and sulbactam in serum and lung tissue were determined and showed adequate levels to cope with usual bacteria in lung surgery. There was one superficial wound infection, 2 cases of bronchitis, and 2 cases of pneumonia.
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PMID:Perioperative antibiotic prophylaxis in general thoracic surgery. 129 Jan 78

In a large multinational study, the clinical and bacteriological efficacy of intravenous cefuroxime 750 mg t.i.d. followed by oral cefuroxime axetil 500 mg b.i.d. was compared to that of amoxicillin plus clavulanic acid (CA) administered as 1.2 g intravenously t.i.d. followed by 625 mg orally t.i.d. in the treatment of lower respiratory tract infections in hospitalised patients. A total of 512 patients were entered (256 in each treatment group). All were suffering from pneumonia or acute exacerbations of chronic bronchitis or bronchiectasis and required initial parenteral antibiotic therapy. Parenteral therapy lasted 48 to 72 h and was followed by five days of oral therapy. The clinical responses in the two treatment groups were very similar: 223 of 256 (87.1%) patients were cured or improved with cefuroxime/cefuroxime axetil compared to 220 of 256 (85.9%) with amoxicillin/CA. Positive pre-treatment sputum samples were obtained from 44% of the patients. Clearance rates obtained were again similar: 72.8% with cefuroxime/cefuroxime axetil and 70% with amoxicillin/CA. Ten percent of the isolates were beta-lactamase producers, similar numbers of which were cleared in both groups. Both regimens were generally well tolerated, with only 5% of patients treated with the cefuroxime regimen and 4.3% of patients treated with amoxicillin/CA experiencing drug-related adverse events. Cefuroxime/cefuroxime axetil "follow-on" therapy produces clinical and bacteriological efficacy equivalent to that of amoxicillin/CA, with the advantage of twice daily oral administration.
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PMID:Cefuroxime and cefuroxime axetil versus amoxicillin plus clavulanic acid in the treatment of lower respiratory tract infections. 139 25

To investigate the relationship of efficacy of chemotherapy to host defense, we reviewed the clinical features, treatment and outcome in 648 patients with acute pneumonia (424 males and 224 females; mean age, 65 years) treated between 1984 and 1989. Pneumonia complicated pulmonary disease in 336 patients (52%) and complicated systemic disease in 258 (40%). Pneumonia pathogens were diagnosed in 346 patients (53%); the five major pathogens were S. pneumoniae (19%), H. influenzae (16%), S. aureus (14%), K. pneumoniae (14%) and P. aeruginosa (11%). The incidence of K. pneumoniae infection were decreased from 18% to 3.5% and that of S. aureus increased from 10.9% to 26.3% during the study period. The incidence of S. aureus and of P. aeruginosa infection was much higher in patients with nosocomial pneumonia, systemic disease, or serum protein concentration under 6.5 g/dl. beta-lactamase antibiotics were administered to 70% of all patients, with an efficacy rate of 74.9% of after the first course of antibiotics therapy. The efficacy rate was decreased in patients with nosocomial pneumonia, systemic or pulmonary disease, or malnutrition. The data presented in this study indicate that the risk of pneumonia must be taken into careful consideration in patients with compromising complications.
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PMID:[Etiology of pneumonia and host defense]. 143 88

Clinical efficacy and safety of cefprozil (CFPZ, BMY-28100), a newly developed oral cephalosporin, were studied in our pediatric department. Clinical effectiveness, bacteriological effectiveness and side effects were studied in 116 pediatric patients with ages ranging 4 months to 11 years. CFPZ was given 4.6-14.1 mg/kg daily in 3 times for 3-10 days. Clinical efficacies were evaluated in 112 patients, and the therapeutic effectiveness were excellent in 1 and good in 6 for 7 patients with acute pharyngitis, excellent in 24 and good in 26 for acute purulent tonsillitis, excellent in 3, good in 8 and fair in 1 for acute bronchitis, excellent in 21, good in 7, fair in 1 and poor in 1 for acute pneumonia, excellent in 1 acute purulent parotitis, excellent in 2 and good in 7 for acute UTI, good in 1 impetigo, fair in 1 periproctal abscess and good in 1 acute enteritis. The effectiveness rate was 96.4%. Bacteriologically, 4 strains of Staphylococcus aureus (beta-lactamase producing strains), 1 strain of Staphylococcus epidermidis (beta-lactamase producing strain), 2 strains of Streptococcus pneumoniae, 2 strains of Streptococcus agalactiae, 4 strains of beta-Streptococcus, 1 strain of Klebsiella pneumoniae (beta-lactamase producing strain) and 1 strain of Salmonella C2 were all disappeared, and of 22 strains of Streptococcus pyogenes, 20 strains were disappeared, 1 was decreased and 1 was unknown, of 5 strains of Escherichia coli (3 beta-lactamase producing strains), 4 were disappeared and 1 was decreased, of 29 strains of Haemophilus influenzae (14 beta-lactamase producing strains), 14 were disappeared, 11 were decreased, 3 persisted and 1 was unknown and of 2 strains of Haemophilus parainfluenzae (1 beta-lactamase producing strain), 1 was disappeared and 1 persisted. The bacteriological eradication rates for Gram-positive bacteria and Gram-negative bacteria were 97.1% and 56.8%, respectively, and the drug was especially effective against Gram-positive bacteria. No side effects nor refusal of ingestion were observed. As abnormalities in laboratory test results, 3 cases of elevation of eosinophil counts and 1 of elevation of platelet counts were observed. In conclusion, CFPZ was considered to be a safe and highly effective antibiotic in pediatric infections.
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PMID:[Clinical study on cefprozil in pediatrics]. 149 36

The use of cefaclor advanced formulation (cefaclor AF) in the treatment of pneumonia caused by susceptible organisms was investigated in a multi-center trial conducted in the United Kingdom and the United States. A total of 266 patients were enrolled in this double-blind, double-dummy, randomized, parallel study; 132 patients were treated with cefaclor AF and 134 patients received the reference drug cefaclor. Inclusion criteria were a diagnosis of lobar pneumonia or bronchopneumonia, with a positive sputum culture and an infiltrate on chest roentgenogram. Patients received either cefaclor AF (750 mg twice daily) or cefaclor (500 mg three times daily) for 10 to 14 days. Forty patients in the cefaclor AF group and 45 in the cefaclor group were evaluable for efficacy, with 37 (92.5%) and 43 (95.6%), respectively, showing a favorable posttherapy clinical response. Proven or presumed pathogen elimination was achieved in 87.5% and 86.7% of cases, respectively. Both study drugs demonstrated high levels of activity against Streptococcus pneumoniae, Haemophilus influenzae (including beta-lactamase-producing strains), and Moraxella catarrhalis (including beta-lactamase-producing strains). There were no statistically significant differences between drugs in efficacy results. One or more side effects were reported by 42.4% of the patients treated with cefaclor AF and by 44.0% of those treated with cefaclor; diarrhea, nausea, headache, and respiratory disorders were the most common adverse events. No drug-related side effects were seen with a frequency or severity that would be unexpected with the use of oral cephalosporins. Cefaclor AF and cefaclor performed equally well with respect to clinical and bacteriologic response rates in the treatment of pneumonia.
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PMID:Cefaclor advanced formulation versus cefaclor in the treatment of pneumonia. 152 91


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