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Query: UMLS:C0032285 (
pneumonia
)
54,520
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Pneumonia
counts as one of the most frequent severe Haemophilus influenzae infections to afflict adults. 60% of patients with
pneumonia
caused by type b H. influenzae are more than 50 years old, 30% to 40% are alcoholics, and 30% to 40% have chronic pulmonary disease or other concurrent illness. In the majority of cases there is multilobular, maculate, diffuse and usually bilateral involvement of the pulmonary tissue. The mortality rate due to type b H. influenzae
pneumonia
ranges between 30% and 40%. In patients with non-bacteriaemic
pneumonia
caused by non-encapsulated strains of H. influenzae it is rare for several lobes to be involved, there is little exudation and the mortality rate is low. H. influenzae is a significant pathogen in acute epiglottitis in adults and it also appears to play an important role in acute exacerbations of chronic obstructive lung disease (COLD) and acute sinusitis.
beta-lactamase
production mediated by R-factors or plasmids of gram-negative bacteria is responsible for ampicillin resistance. In 1978 the overall rate of resistance of H. influenzae to ampicillin in American hospitals amounted to 18%. H. influenzae are found in the nasopharynx of people exposed to others infected with H. influenzae. The risk of secondary infection in children who come into contact with patients infected with type b H. influenzae amounts to approximately 2.1%. Adults in close contact with children suffering from severe H. influenzae infections must be warned of the possible risks of secondary infection.
...
PMID:[Respiratory tract infections caused by Haemophilus influenzae in adults]. 349 6
The comparative efficacies of ticarcillin and ticarcillin plus clavulanic acid have been determined in the mouse against experimental infections caused by ticarcillin-resistant bacteria. The infections studied comprised an intraperitoneal infection, local tissue infections, pyelonephritis, and
pneumonia
. Both ticarcillin and clavulanic acid penetrated readily to the sites of infection studied and at the doses employed were present at concentrations of the same order as those obtained in humans after the administration of ticarcillin-clavulanic acid formulations (Timentin; Beecham). At these concentrations, the ticarcillin-clavulanic acid combination caused significant bactericidal effects at the sites of infection against the ticarcillin-resistant strains of Bacteroides fragilis, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus investigated. The efficacy of ticarcillin plus clavulanic acid against the infections resistant to therapy with ticarcillin demonstrated the
beta-lactamase
-inhibitory activity of clavulanic acid in vivo.
...
PMID:Bactericidal effects of ticarcillin-clavulanic acid against beta-lactamase-producing bacteria in vivo. 352 31
Cystic fibrosis is the most common lethal genetic disease of Caucasians. The disease affects the exocrine gland secretions throughout the body, and as a result, major pathologic changes develop in the pancreas and in the bronchi. Obstruction of the respiratory airways results in chronic infection, and in time, this leads to progressive deterioration of lung function. In the initial stages of the disease, usually during infancy, infection with Staphylococcus aureus plays an important role. Hemophilus influenzae infections are also common. As the disease progresses, infection with Pseudomonas aeruginosa develops. Exacerbation of bronchopulmonary infection is often initiated by respiratory viral or mycoplasmal infection, with superimposed S. aureus and P. aeruginosa infections contributing to the severity of the infection. Frequent courses of antibiotic therapy are usually required, and some patients may have to receive antibiotics continuously. Oral cephalosporins, ampicillin, and the combination of trimethoprim/sulfamethoxazole are commonly used for relatively mild infections. In the treatment of exacerbation of infection, intravenous
penicillinase
-resistant penicillins and anti-Pseudomonas antibiotics are the drugs of choice. For Pseudomonas infections, ticarcillin, carbenicillin, the ureidopenicillins, and the aminoglycosides are indicated. The combination of an anti-Pseudomonas penicillin and an aminoglycoside are most commonly used. Of the third-generation cephalosporins, ceftazidime appears to be the most efficacious. The quinolones (such as ciprofloxacin) are also active against P. aeruginosa, and preliminary studies of these drugs in patients with cystic fibrosis appear to indicate that they are as efficacious as the already available antibiotics. In many centers, Pseudomonas cepacia has emerged as a serious problem in patients with cystic fibrosis. This organism tends to develop resistance to multiple antibiotics. In some centers, infection with P. cepacia has been associated with a severe, frequently fatal,
pneumonia
.
...
PMID:Infection in patients with cystic fibrosis. 352 81
Branhamella catarrhalis has been implicated previously as a cause of bronchopulmonary infections. Sputum Gram's stain and culture results suggesting significant infection with
beta-lactamase
-producing strains of B. catarrhalis were correlated with a retrospective chart review of eight pediatric and ten adult patients. Preexisting pulmonary disease was observed in 12 patients; 5 had a history of aspiration; and 13 were intubated. Clinically, ten patients had
pneumonia
, five had bronchitis, and three manifested no disease. Only three sputum specimens grew a pure culture of B. catarrhalis, and six specimens yielded B. catarrhalis in the presence of normal upper respiratory flora. Analysis of broth microdilution susceptibility test results showed that 90% of the strains were inhibited at the following minimum inhibitory concentrations (MICs90): ampicillin, 8 micrograms/mL; cefotaxime, 0.5 microgram/mL; cefoxitin, 0.5 microgram/mL; cephalexin, 4 micrograms/mL; cephalothin, 8 micrograms/mL; chloramphenicol, 1 microgram/mL; clindamycin, 4 micrograms/mL; erythromycin, 0.25 microgram/mL; methicillin, 16 micrograms/mL; mezlocillin, 16 micrograms/mL; moxalactam less than or equal to 0.6 microgram/mL; penicillin, 16 micrograms/mL; piperacillin, 8 micrograms/mL; tetracycline, less than or equal to 0.3 microgram/mL; and trimethoprim/sulfamethoxazole, 1.6/30 micrograms/mL. Therapy may have been adequate in only eight (44%) of the cases. However, all but four of the patients, who died of unrelated causes, exhibited resolution of disease. The data indicate that Gram's stain and culture results of sputum specimens suggesting B. catarrhalis bronchopulmonary infection should be interpreted with caution by clinicians.
...
PMID:Clinical interpretation of beta-lactamase-producing strains of Branhamella catarrhalis in sputum Gram's stain and culture. 354 21
Rhodococcus equi, formerly known as Corynebacterium equi, was isolated repeatedly from the blood of two patients with the acquired immune deficiency syndrome (AIDS). Neither of the patients had
pneumonia
while they were bacteraemic, whereas
pneumonia
has been present in all previously reported cases of human infection with R equi. One of our patients had diarrhoea and the organism was isolated from a stool culture; the other patient had a large granulomatous soft tissue mass in his pelvis caused by R equi. Both isolates were resistant to penicillin and one produced a
beta-lactamase
. Both patients were treated with vancomycin but only one recovered.
...
PMID:Non-pulmonary Rhodococcus equi infections in patients with acquired immune deficiency syndrome (AIDS). 358 8
Cigarette smoking exerts deleterious effects not only on the respiratory tract, but also on the lung's parenchyma. The FEV is reduced in heavy chronic smokers. Persistent smoking has an unfavourable influence on mucociliary activity. According to the results of recent research almost 8 million people in the U.S. were suffering from chronic bronchitis in 1981. There is a direct correlation between the number of cigarettes smoked, over what period of time, and the incidence of chronic bronchitis. In studies with patients suffering from exacerbations of chronic bronchitis the most common bacterial pathogens found were Haemophilus influenzae, Streptococcus pneumoniae and Branhamella catarrhalis. Mycoplasma pneumoniae and certain viruses are counted amongst the non-bacterial pathogens. Antibiotics should be effective against such possible pathogens. The resistance of H. influenzae to ampicillin/amoxicillin is currently observed in at least 12% of cases, whilst H. influenzae is regularly observed to be resistant to erythromycin. Cefaclor, trimethoprim/sulphamethoxazole and amoxicillin/clavulanic acid offer satisfactory forms of treatment.
Pneumonia
caused by S. pneumoniae, H. influenzae, B. catarrhalis and Legionella pneumophila is often seen in smokers and patients with COLD. Haemocultures should be prepared for all hospitalized patients. Penicillin G and/or V is the agent of choice. Cefaclor or trimethoprim/sulphamethoxazole can be given to counter
beta-lactamase
producing H. influenzae whilst cefaclor, erythromycin, tetracycline or trimethoprim/sulphamethoxazole are used for the treatment of B. catarrhalis infections. In Legionella infections erythromycin is the preferred treatment. A combination of erythromycin and cefamandole or ceftriaxone is indicated for empirical management. Patients with COLD should be immunised with pneumococcus and influenza vaccines.
...
PMID:[Smoking and lower respiratory tract infection]. 361 Mar 32
Forty children all aged over 2 years and eutrophic were treated with the combination amoxycillin and clavulanic acid for various infections (twenty-three with meningitis, eleven with bronchial
pneumonia
, three with typhoid fever, two with lower urinary tract infections and one with ear infection of moderate severity). Nine of these patients had sickness during treatment which was mild and transient in the majority of cases and caused treatment to be stopped in only one case (2.5%). This low level of gastric tolerance should not concern the paediatrician faced with an infection due to (or most likely to be) a
beta-lactamase
producing micro-organism.
...
PMID:[Tolerance of amoxicillin-clavulanic acid combination in the child]. 372 Oct 56
A new
beta-lactamase
-stable oral cephem antibiotic, cefixime (CFIX), was evaluated for safety, efficacy and pharmacokinetics in children. CFIX was effective in 19 of 20 cases (95%) with bacterial infections. The drug was especially effective against the cases of
pneumonia
due to
beta-lactamase
-producing H. influenzae or B. catarrhalis. Pharmacokinetic parameters of CFIX (3 mg/kg) with premeal administration were as follows: Kel 0.328 +/- 0.066 hr-1, T 1/2 2.14 +/- 0.36 hrs, AUC 10.9 +/- 8.7 micrograms X hr/ml, and Vd/F 1.64 +/- 1.42 L/kg. In most of the cases tested, the urinary excretion rate in 12 hours was 5 to 17%. A dose of 3 mg/kg twice daily seems to be adequate for a regular treatment.
...
PMID:[Clinical evaluation of cefixime in children]. 376 34
Fundamental and clinical studies were carried out on cefixime (CFIX) 5% granules, and the results are summarized below. Antimicrobial activity Antimicrobial activities of CFIX, cefaclor, cefroxadine, cephalexin and amoxicillin (AMPC) were studied against clinical isolates. CFIX showed greater activities than all the other antibiotics against E. coli, K. pneumoniae, H. influenzae, P. mirabilis, E. cloacae and S. marcescens, but it was slightly less active than AMPC against S. pyogenes. Absorption and excretion Serum concentrations and urinary excretions of CFIX were determined following single or repeated oral administration. In 8 patients given single dose of CFIX 1.5 or 3.0 mg/kg, mean serum concentrations were 1.27 and 1.09 micrograms/ml at 2 hours, 1.27 and 1.35 micrograms/ml at 4 hours, 0.85 and 1.10 micrograms/ml at 6 hours, 0.17 and 0.24 micrograms/ml 12 hours after administration, respectively. Mean serum half-lives were 2.54 hours for the dose of 1.5 mg/kg and 2.60 hours for 3.0 mg/kg. Urinary recovery rates in the 12-hours urine varied 6.7 to 33.6%, with an average of 13.5%. In 3 patients given a repeated dose of CFIX 3.0 or 5.6 mg/kg b.i.d., the serum concentrations were 0.23-1.01 micrograms/ml at 0 hour, 1.91-2.80 micrograms/ml at 2-4 hours and 1.13-2.07 micrograms/ml at 6-8 hours after administration. Clinical study The CFIX was given orally by mainly b.i.d. at a daily dose of 4.4-11.6 mg/kg for 4-15 days to a total of 33 patients consisting of 3 patients with
pneumonia
, 3 with bronchitis, 9 with tonsillitis, 15 with UTI, one each with scarlet fever, lymphadenitis and colitis. Clinical responses were excellent in 24 patients, good in 8 and fair in 1, with an effectiveness rate of 97.0%. All of the 21 bacterial isolates examined were eradicated after CFIX treatments including 3
beta-lactamase
producing strains. No side effects of abnormal laboratory findings were observed in these patients.
...
PMID:[Fundamental and clinical studies on cefixime (5% granules) in the pediatric field]. 376 37
Fundamental and clinical studies on BRL 25000 granules were carried out in the pediatric field. BRL 25000 is a formulation comprising 1 part of clavulanic acid (CVA) and 2 parts of amoxicillin (AMPC). The MICs of BRL 25000 and AMPC were assessed against 24 clinically isolated strains of S. aureus (including 23
beta-lactamase
producing strains), 22 S. pyogenes, 20 E. coli (8
beta-lactamase
producing strains), 24 K. pneumoniae (24
beta-lactamase
producing strains), 20 H. influenzae (6
beta-lactamase
producing strains). BRL 25000 showed MIC80 (cumulatively 80% of strains were inhibited) at 6.25 micrograms/ml against S. aureus, less than or equal to 0.10 micrograms/ml against inst S. pyogenes, 12.5 micrograms/ml against E. coli, 6.25 micrograms/ml against K. pneumoniae and 0.39 micrograms/ml against H. influenzae. BRL 25000 showed no improvement in MIC terms against
beta-lactamase
nonproducing strains compared with AMPC. However, BRL 25000 was markedly more effective against
beta-lactamase
producing strains. Thus BRL 25000 was up to 8 fold more active against S. aureus, 2 to 64 fold against E. coli, 4 to 128 fold against K. pneumoniae, 4 to 16 fold against H. influenzae than AMPC. Following oral administration of BRL 25000 granules (at a dose level of 12.5 mg/kg) to 2 children aged 9 and 11 years, the mean peak serum concentrations of AMPC and CVA were 8.33 +/- 2.43 micrograms/ml and 4.44 +/- 1.65 micrograms/ml respectively 1 hour after dosing. The half-lives of AMPC and CVA were 1.35 +/- 0.42 hours and 0.91 +/- 0.05 hour, respectively. The urinary excretion was 48.21 +/- 3.83% for AMPC and 16.90 +/- 7.06% for CVA in the first 6 hours after administration. In clinical studies, 23 pediatric patients aged 2 months to 12 years with bacterial infections were treated with BRL 25000 granules and the clinical effectiveness, bacteriological response and side effects were evaluated. The clinical response was assessed in 23 cases, 3 with acute rhinitis, 6 with acute purulent tonsillitis, 5 with acute bronchitis, 4 with acute
pneumonia
, 3 with impetigo, 1 with furunculosis and 1 with periproctal abscess. Results were excellent in 13 cases, good in 7, fair in 3 and hence the efficacy rate (excellent and good cases) was 87.0% (20/23). In particular the clinical response in 9 cases with infections due to
beta-lactamase
producing organisms was excellent in 6, good in 2, fair in 1 and the efficacy rate was 88.9% (8/9).(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:[Experimental and clinical studies on BRL 25000 (clavulanic acid-amoxicillin) in the pediatric field]. 384 22
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