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)

Clindamycin-2-phosphate (7(S)-chloro-7-deoxylincomycin-2-phosphate) is a new semi-synthetic antibiotic. It is recognized that the drug itself is inactive against bacteria in vitro but it is hydrolyzed rapidly to active clindamycin, drug intramuscular or intravenous administration. Clindamycin-2-phosphate was administrated intravenously to seven patients with infections, except one intramuscularly, 300 approximately 600 mg, every 8 or 12 hours a day, for 2 approximately 12 days. Three patients (1 bacterial pneumonia, 1 chronic bronchitis and 1 urinary tract infection due to E. coli) recovered from their infection; one patient (bacterial infection in bronchiectasis) partially responded; and three patients (1 urinary tract infection due to E. coli, 1 pneumonia due to Mycoplasma pneumoniae and 1 patient with mycoplasmal pneumonia and acute biliary tract infection) failed to respond to the drug. No remarkable side effect was noted except pain at intramuscular injection site in one patient.
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PMID:[Clinical evaluation of clindamycin-2-phosphate in infectious diseases (author's transl)]. 32 Mar 61

Considerable controversy exists as to whether or not antibiotics should be administered "prophylactically" to patients with penetrating chest trauma. No prospective study of this problem has been reported. Therefore, 75 patients with isolated, penetrating chest injury were randomized prospectively in a double-blind study. Group A patients (38 patients) were given 300 mg. of clindamycin phosphate every 6 hours, beginning with admission and lasting until 1 day following chest tube removal or for 5 days, whichever was shorter. Group B patients (37 patients) were given a placebo on the same schedule. The patients' hospital course, fever, white blood count, culture data, and roentgenograms were recorded serially. Clindamycin-treated patients had a significantly lower incidence of radiographic pneumonia, less fever, and a lower incidence of positive pleural and wound cultures. They acquired empyema less frequently, required fewer operations, and had a shorter period of hospitalization. Antibiotics may be useful, therefore, as adjunctive therapy in the management of penetrating chest trauma.
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PMID:Prophylactic antibiotics in the treatment of penetrating chest wounds. A prospective double-blind study. 33 88

Twenty-eight patients with anaerobic pleuropulmonary infections were treated with clindamycin alone or clindamycin with gentamicin. Sixteen of the patients presented with pneumonitis, nine with necrotizing pneumonia, and three with lung abscesses. The average length of treatment was 13.8 days, and the duration of temperature after initiation of therapy was 3.1 days. The predominant isolates were anaerobic gram-positive cocci (23 isolates), Bacteroides melaninogenicus (14), Bacteroides fragilis (9), and Fusobacterium nucleatum (11). The most frequent aerobic isolates were alpha-hemolytic streptococci (12), Diplococcus pneumoniae (12), Pseudomonas aeruginosa (9), Klebsiella pneumoniae (7), group A beta-hemolytic streptococci (5), Staphylococcus aureus (9), and Escherichia coli (6). All patients responded to the therapy and were cured of the infection. There were no side effects observed from the administration of clindamycin. None of the patients developed any blood dyscrasia, liver damage, diarrhea, or colitis. Clindamycin appears to be effective in the treatment of mixed aerobic and anaerobic pleuropulmonary infections in children, alone or with an aminoglycoside when indicated.
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PMID:Clindamycin in treatment of aspiration pneumonia in children. 38 Apr 59

Preclinical and clinical studies of clindamycin-2-phosphate developed as an infectable were conducted, and the following results were obtained: 1) Clindamycin-2-phosphate administered by the intravenous drip in a dose of 600 mg over one hour showed a peak blood clindamycin level of 10.5 mcg/ml at the end of administration. Though the blood level then decreased rapidly, it stayed at 0.7 mcg/ml at 8 hours later. 2) The blood level of clindamycin following intramuscular injection of 300 mg of clindamycin-2-phosphate reached a peak of 3.3 mcg/ml at one hour later. The blood level of 6 hours after injection was 1.0 mcg/ml. 3) Clindamycin-2-phosphate 300 mg was given intramuscularly 2 to 4 times daily for 5 approximately 14 days in 4 cases of pneumonia. The drug proved effective in two cases of pneumonia due to Mycoplasma; fairly effective in another case of mixed infection caused by pneumococci, Hemophilus and N. meningitidis; and ineffective in the fourth case of infection due to Hemophilus parainfluenzae. 4) No such adverse reactions as hepatic disorder, renal disorder and colitis were noted following administration of clindamycin-2-phosphate.
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PMID:[Preclinical and clinical studies of clindamycin-2-phosphate (author's transl)]. 83 43

The first case was a 73-year-old woman with chief complaints of fever, cough, purulent sputum and dyspnea. EM therapy was begun in December 1983 due to a diagnosis of diffuse panbronchiolitis (DPB). Subsequently, P. aeruginosa was persistently detected, while in February 1991 at the time of an acute exacerbation of the DPB P. aeruginosa and S. pneumoniae were detected by TTA. The second case was a 65-year-old man with chief complaints of fever, cough and purulent sputum. DPB was diagnosed and EM therapy was begun in December 1985. In January 1991, pneumonia developed, at the time when S. pneumoniae was detected by TTA. In both cases, rapid disappearance of S. pneumoniae from the sputum and alleviation of symptoms were obtained with carbapenem antibiotic administration. Both strains were resistant to EM, Tetracycline (TC), Minocycline (MINO) and Clindamycin (CLDM). Particularly, S. pneumoniae of case 2 showed low sensitivity to Ampicillin (ABPC), Cefotiam (CTM) and Cefoxitin (CFX) as well. These cases showed acute exacerbations due to EM-resistant pneumococcus during long-term therapy with EM, and are of interest in that they may shed light on the relation between long-term EM therapy and the emergence of resistant pneumococcus.
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PMID:[Two cases of diffuse panbronchiolitis receiving long-term erythromycin (EM) therapy with acute exacerbation due to EM-resistant pneumococcus]. 143 55

Suppurative complications to aspiration pneumonia occur if the initial aspiration and subsequent pneumonitis go unrecognized or untreated. Anaerobic cavitary disease is typically an indolent process, whereas necrotizing pneumonia is more fulminant and deadly. Rarely are aggressive diagnostic measures necessary in the community-acquired setting. Most patients, even with necrotizing pneumonia, respond well to high-dose penicillin and show clinical improvement within a week to 10 days. Clindamycin may be preferred in cases of severe underlying disease or when penicillin fails to yield signs of recovery. The presence of empyema not only increases the duration of therapy but also is fraught with complications and carries a higher mortality rate (20 vs 5 per cent). Necrotizing pneumonia and pulmonary abscess that develop in the nursing home or hospital setting require a more aggressive diagnostic approach, and broad-spectrum antibiotic coverage is necessary. In spite of these measures and appropriate antibiotic selection, nosocomial-acquired disease carries a mortality rate of 30 to 50 per cent. Surgical intervention, once the mainstay of therapy, is now reserved for patients with complications such as massive hemoptysis, failure to respond to chest tube thoracostomy in the presence of empyema, abscess drainage that fails with postural drainage, and diagnosis of carcinoma.
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PMID:Aspiration pneumonia, necrotizing pneumonia, and lung abscess. 265 1

An 84-year-old woman with acute myelocytic leukemia presented with fever and a left upper lobe infiltrate on chest x-ray. She failed to respond to initial broad spectrum antibiotic therapy. Bronchoalveolar lavage fluid and a transthoracic needle aspirate subsequently both grew Rothia dentocariosa, a gram-positive branching rod. The pneumonia resolved after prolonged treatment with Clindamycin. Rothia dentocariosa must be considered a cause of opportunistic pulmonary infection.
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PMID:Rothia dentocariosa pneumonia in an immunocompromised patient. 311 52

The majority of lower respiratory tract infections (LRTI) are treated "blindly" because the establishment of an aetiological diagnosis is not possible in most cases. The rational choice of therapy mainly rests upon the knowledge of the microbiological epidemiology of LRTI, and on the possible host-parasite relationship. In community-acquired pneumonia, there is general concensus that penicillin maintains its position as the first drug of choice, and that therapy can be changed to erythromycin or tetracycline in cases of therapeutic failure. Treatment of nosocomial pneumonia, and LRTI in immunocompromised patients, calls for antibiotics with a broader antimicrobial spectrum. Clindamycin has an antimicrobial spectrum which makes this antibiotic a possible alternative in community-acquired pneumonia, and its efficacy in pneumococcal pneumonia has been documented. However, as first choice therapy it should be reserved for cases of penicillin allergy, or cases of strongly suspected staphylococcal pneumonia. In aspiration pneumonia--nearly always caused by anaerobic bacteria--penicillin has long been the preferred therapy, even in cases with Bacteroides fragilis. However, recent publications have clearly documented that in primary lung abscess, clindamycin is superior to penicillin. These results are especially important since metronidazole has been shown to be less effective in such cases.
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PMID:Use of clindamycin in lower respiratory tract infections. 659 21

Clindamycin used alone or in combination with other antimicrobial drugs such as aminoglycosides, dioxidin and fluoroquinolones in the prophylaxis and treatment of infectious complications in oncological patients was shown to be highly efficient. When clindamycin was used prophylactically in combination with netilmicin, the postoperative infectious complications developed in 3 out of 27 patients with tumors of the head and neck, in 1 out of 24 patients with tumors of the rectum and colon and in 3 out of 16 patients with tumors of the female genitalia. The clinical effect was observed in 36 (87.8 per cent) out of 41 patients with postoperative wound infections and in 38 (82.5 per cent) out of 40 patients with pneumonia. Therefore, the use of clindamycin alone or in combination with other antimicrobial drugs is essential in the treatment of infectious complications in oncological patients.
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PMID:[The use of clindamycin in the prevention and treatment of infectious complications in the cancer clinic]. 797 97

Actinobacillus actinomycetemcomitans is an important cause of human pulmonary infections, either alone or with Actinomyces species. It may be critical to isolate Actinobacillus in patients with pulmonary infection for selection of an effective antimicrobial regimen. Clindamycin has superseded penicillin as the sole antimicrobial drug for anaerobic bacterial necrotizing pneumonia and abscess. In the case presented herein, therapy with clindamycin failed to halt worsening necrotizing pneumonia or to prevent hematogenous dissemination. After clindamycin-resistant A. actinomycetemcomitans in addition to Actinomyces israelii were isolated, the patient was treated with penicillin, ciprofloxacin, and cefazolin and was ultimately cured.
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PMID:Necrotizing pneumonia caused by mixed infection with Actinobacillus actinomycetemcomitans and Actinomyces israelii: case report and review. 801 34


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