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

In an open study, 70 in-patients and 23 out-patients aged between 1 and 14 years with sinusitis (n = 1), perforated otitis media (n = 4), pharyngotonsillitis (n = 25), tracheobronchitis (n = 30) or broncho-pneumonia (n = 33) were treated daily with a combination of 40 mg/kg amoxycillin and 10 mg/kg clavulanic acid in three equal doses for between 6 and 15 days. Purulent specimens were cultured when obtainable and pathogenic organisms identified were Staphylococcus aureus, beta-haemolytic streptococcal group A, Pseudomonas aeruginosa, Pseudococcus species and Klebsiella pneumoniae infections, of which 45.7% were beta-lactamase-producing and 54.3% were ampicillin-susceptible. After treatment, only one beta-lactamase-producing Streptococcus and one Staphylococcus infection persisted. Side-effects (vomiting, nausea, diarrhoea, maculopapular exanthema, rash) occurred in 16 patients and treatment was withdrawn in eight. It is concluded that the amoxycillin--clavulanic acid combination is a suitable first choice for the treatment of respiratory tract infections in children in whom the pathogenic organism may not have been established.
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PMID:Treatment of respiratory tract infections in children: a study of a combination of amoxycillin and clavulanic acid. 222 80

The epidemiology of community-acquired respiratory tract infections (RTI) is reviewed with emphasis on acute pharyngitis, otitis media, sinusitis, epiglottitis and pneumonia. The numerical importance of upper respiratory tract infections is stressed and their economic impact discussed. Community-acquired pneumonia, although less common, is a more serious infection with a frequent requirement for hospitalization. The heterogeneous microbial aetiology of RTI is stressed, together with the impact this has on chemotherapeutic choice. The latter is likely to remain largely empirical and based on the prevalence of identified pathogens, spectrum of activity and the pharmacokinetic behaviour of the selected agents. The increasing frequency of resistance among respiratory pathogens, notably Haemophilus influenzae, and to a lesser extent Streptococcus pneumoniae, together with the high incidence of beta-lactamase production among Branhamella catarrhalis is of concern. In addition, the issue of beta-lactam inactivation by commensal bacteria suggests that chemotherapeutic strategies for the control of community-acquired respiratory tract infection might justifiably be reconsidered.
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PMID:Epidemiological features and chemotherapy of community-acquired respiratory tract infections. 229 31

In July 1987 non-typable Haemophilus influenzae strains resistant to both ampicillin and chloramphenicol were isolated from the endotracheal aspirate of two children with pneumonia at Baragwanath Hospital, Johannesburg, South Africa. A study was therefore undertaken to determine the carriage rates of Haemophilus influenzae strains in the nasopharynx of children and staff in the index ward and in three control wards. Using a disc diffusion and an agar dilution method the susceptibility was determined of 100 isolates to ampicillin, chloramphenicol, erythromycin, rifampicin, amoxicillin/clavulanic acid, gentamicin, cefaclor, cefotaxime, tetracycline, sulphamethoxazole, trimethoprim and trimethoprim/sulphamethoxazole (1:19). The overall carriage rate of Haemophilus influenzae on admission was 76%. In the index ward, children carrying multiply resistant strains differed from the other children in that there was a longer mean duration of hospitalization, a lower proportion of males, and a higher proportion who had previously received antibiotics. All ampicillin resistant strains were shown to produce beta-lactamase. Only four isolates belonged to serotype b, of which three were ampicillin resistant and chloramphenicol sensitive while one was resistant to both drugs. Nasopharyngeal spread of resistant non-typable strains of Haemophilus influenzae was demonstrated to affect the management of paediatric patients in the hospital.
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PMID:Spread of non-typable multiply resistant Haemophilus influenzae in a South African hospital. 230 63

Branhamella catarrhalis is an important cause of acute sinusitis and otitis media in children and of acute tracheobronchitis in older persons with underlying chronic lung disease or a suppressed immune system. Clinical presentation of B catarrhalis infection varies from a mild, self-limiting disease to severe pneumonia, but most cases are mild to moderate in severity. Infection occurs sporadically, and endogenous spread from the oropharynx is the likely mechanism. The keys to diagnosis are a high index of clinical suspicion, correct interpretation of Gram's stain of sputum, and subsequent confirmation on culture. Because most strains of B catarrhalis produce beta lactamase, antibiotics that resist beta-lactamase production, eg, amoxicillin-clavulanic acid (Augmentin), erythromycin, ciprofloxacin (Cipro), are recommended. Mild infections can be self-limiting and may not require antibiotic therapy.
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PMID:Branhamella infections. An increasingly common respiratory illness. 249 49

Isolates of Branhamella catarrhalis from 13 patients with pneumonia, 6 patients with tracheobronchitis, and 8 patients who were colonized with the organism were studied with respect to susceptibility to the bactericidal action of normal human serum (NHS), glass slide hemagglutination (HA) of group O human erythrocytes, beta-lactamase production, and susceptibility to selected antimicrobial agents and laboratory drugs. A total of 18 of 27 isolates were serum resistant, 22 of 27 produced HA, and 21 of 27 were beta-lactamase positive. Statistically significant correlations were found between susceptibility to NHS and susceptibility to trypsin (r = +0.47; P = 0.01) and between susceptibility to NHS and HA (r = -0.48; P = 0.009). Significant correlations were also observed among several pairs of antimicrobial drugs. Analysis of variance showed that mean ampicillin MICs correlated with isolate group (r = -0.49; P = 0.03) in that the pneumonia isolates had higher MICs. Some phenotypic characteristics appeared to be independent of each other. These data suggest that important differences exist among clinically significant B. catarrhalis strains and that these differences may be due to differences in the cell wall envelope of the organism.
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PMID:Phenotypic characteristics of Branhamella catarrhalis strains. 250 53

This is the first time Branhamella Catarrhalis has been identified as a lower respiratory tract pathogen in Taiwan. All 4 patients with B. catarrhalis pneumonia reported herein had a certain degree of underlying pulmonary dysfunction. Two patients had pure B. catarrhalis infection, whilst the other two had concomitant infections with Haemophilus influenzae or Viridans streptococci. Amongst the 3 strains of B. catarrhalis examined, all were capable of producing beta-lactamase. By using the Kirby-Bauer method, 2 of these strains were observed as penicillin resistant. Therefore, patients with poor clinical response to penicillin, ampicillin, and cephapirin were treated effectively with trimethoprim/sulfamethoxazole or ofloxacin. B. catarrhalis should no longer be regarded as a normal flora of the sputum in patients with lower respiratory tract infections. Beta-lactamase production should be tested for each isolated strain to avoid failure of penicillin therapy due to bacterial resistance.
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PMID:Branhamella catarrhalis pneumonia: report of 4 cases. 250 37

Branhamella catarrhalis is commonly considered a respiratory commensal but has recently been implicated as a pathogen, particularly in adults. Over a 28 month period, B. catarrhalis was isolated from bronchopulmonary secretions of 14 PICU patients with acute respiratory infections. Twelve patients had pneumonia and two had tracheitis. The mean age was 3.5 years. Seven patients had chronic cardiopulmonary disease including two who were immunosuppressed. Three had an acute underlying condition and four had no complicating medical problem. Polymorphs and Gram-negative diplococci on Gram stain were found in respiratory secretions of all patients. Twelve of 14 isolates produced beta-lactamase, and six patients had a second potentially pathogenic bronchopulmonary isolate. All patients were treated for B. catarrhalis infection and none died. When isolated in pure culture from bronchopulmonary secretions in symptomatic patients, B. catarrhalis should be considered a pathogen. When isolated in mixed culture, its pathogenic role is uncertain. We conclude that B. catarrhalis can be a bronchopulmonary pathogen in critically ill children with otherwise normal cardiopulmonary function as well as in those with chronic cardiopulmonary dysfunction. When administering antibiotics the high frequency of beta-lactamase-producing strains must be taken into consideration.
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PMID:Branhamella catarrhalis bronchopulmonary isolates in PICU patients. 250 48

There have been few reports on Branhamella catarrhalis as a nosocomial pathogen, and no risk factors for nosocomial infection have been identified. We report 11 cases (mean age 22 months) of nosocomial Branhamella catarrhalis respiratory tract infection in a paediatric intensive care unit (PICU) over a two-year period. There were 2 cases of pneumonia and 9 cases of bronchitis. Branhamella catarrhalis was the sole isolate recovered in 6 cases and was associated with other respiratory pathogens in 5 cases. A case-control study with two age-matched controls per patient (mean age 24.1 months) was undertaken to identify potential risk factors for infection; risk factors identified were the presence of an endotracheal tube (p less than 0.02) and frequent endotracheal tube suction (p less than 0.05). Five of 6 tested strains from PICU patients produced beta-lactamase. DNA preparations of 4 B. catarrhalis isolates from PICU patients revealed no plasmids. B. catarrhalis should be considered a potential nosocomial pathogen.
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PMID:Nosocomial Branhamella catarrhalis in a paediatric intensive care unit: risk factors for disease. 256 60

Bacteremic Hemophilus influenzae pneumonia is an uncommon infection in the adult. It usually affects chronically ill patients, especially those with chronic obstructive lung disease, although healthy individuals can also be affected. The condition carries a significant mortality, reaching 57% in one series. We describe ten adult patients with bacteremic H influenzae pneumonia with some unique features: no deaths occurred, half of the involved patients were previously fit individuals, and a beta-lactamase producing strain was isolated in five out of ten patients. An interesting finding was the isolation of a beta-lactamase negative H influenza from the sputum of two patients whose blood cultures were positive for a beta-lactamase positive H influenza. The overall incidence of beta-lactamase production among bacteremic isolates was 50%--a finding with a great deal of impact on the treatment of this disease.
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PMID:Bacteremic Hemophilus influenzae pneumonia in the adult. 265 32

Sultamicillin is a substance in which sulbactam, a beta-lactamase inhibitor, is covalently linked through an ester group to ampicillin. This paper describes the results of a clinical trial with sultamicillin in the infectious diseases encountered in internal medicine. In an open segment of the trial, 426 adult patients were treated orally with sultamicillin. The efficacy rates achieved were 86.1% (136/158) in acute respiratory infections, 67.5% (137/203) in chronic respiratory infections, 92.9% (39/42) in acute urinary tract infections, 76.9% (10/13) in chronic urinary tract infections, and 70.0% (7/10) in other types of infections. The bacteriological efficacy of sultamicillin was 83.8% (62/74) for Gram-positive and 74.0% (159/215) for Gram-negative bacteria. Efficacy was similar, 81% (17/21), for those strains that were high producers of beta-lactamase. Adverse reactions were observed in 10.1% of the patients in the open phase of the trial. In the double-blind segment, sultamicillin was compared with bacampicillin in respiratory infections, including pneumonia, lung abscesses, and chronic respiratory tract infections. One tablet of either drug was given orally three times a day for 14 d. Evaluation of clinical effectiveness by the trial committee revealed efficacy rates of 82.8% (96/116) for sultamicillin and 69.8% (81/116) for bacampicillin, indicating a significant superiority for sultamicillin. All of this difference resulted from the superior efficacy of sultamicillin (89.2%) over that of bacampicillin (63.2%) in patients with chronic respiratory infections. Efficacy in pneumonia was the same for both agents. Adverse reactions to sultamicillin and bacampicillin were observed in 16.3% (21/129) and 6.3% (8/127) of the cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sultamicillin experiences in the field of internal medicine. 266 Aug 72


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