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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One of the main uses of erythromycin in respiratory tract infection has been in the treatment of acute streptococcal tonsillitis as an alternative to penicillin. Studies on the quantitative bacteriology of tonsils obtained at tonsillectomy have shown large numbers of both haemolytic streptococci and Haemophilus species in most samples and these organisms can be effectively reduced in number by preoperative treatment with antibiotics such as erythromycin. Such investigations suggest that erythromycin might have wider use in the treatment of respiratory tract infections, particularly where Haemophilus influenzae and other Haemophilus species are involved. Apart from specific infections such as those due to Mycoplasma pneumoniae, erythromycin is effective in the treatment of acute pneumonia due to organisms such as the pneumococcus, and this paper reports the further use of erythromycin in the treatment of acute exacerbations of chronic bronchitis where the clinical and bacteriological effects of treatment with this antibiotic are compared with those of ampicillin.
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PMID:Erythromycin in respiratory tract infection. 41 55

In the winter of 1972-1973 a multicentre trial of the treatment of upper and lower respiratory tract infections was carried out in Spain using doxycycline. 85 physicians participated in the study and treated 1,653 patients. The infections included acute bronchitis, acute exacerbation of chronic bronchitis, pneumonia, bronchopneumonia, tonsillitis, pharyngitis, trachetis, sinusitis, and otitis media. The majority of the patients were adult out-patients although some children and adolescents were included: 1,011 of the patients were male and 642 female. A number of the signs of respiratory infection such as temperature, cough, pain and inflammatory symptoms were examined. A rapid reduction in intensity and severity was noted in all of these parameters. Tolerance to the antibiotic was excellent. Only minor side-effects were reported and these were mild and mainly limited to the gastro-intestinal tract - in no case was treatment discontinued. The total number of side-effects was 37; they occurred in 31 out of the 1,653 patients. The overall evaluation of results showed a very good or good response in 85% of the patients. It appears from this multicentre study that the efficacy of doxycycline has in no way decreased over the 7 years of its extensive use in Spain. It remains a fast acting and effective antibiotic in upper and lower respiratory tract infections irrespective of age, sex or diagnosis.
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PMID:Doxycycline in respiratory tract infections. Report of a retrospective study in Spain during the winter 1972-1973. 109 76

These guidelines deal with the evaluation of anti-infective drugs for the treatment of respiratory tract infections. Five clinical entities are described: streptococcal pharyngitis and tonsillitis, otitis media, sinusitis, bronchitis, and pneumonia. A wide variety of microorganisms are potentially pathogenetic in these diseases; these guidelines focus on the bacterial infections. Inclusion of a patient in a trial of a new drug is based on the clinical entity, with the requirement that a reasonable attempt will be made to establish a specific microbial etiology. Microbiologic evaluation of efficacy requires isolation of the pathogen and testing for in vitro susceptibility. Alternatively, surrogate markers may be used to identify the etiologic agent. The efficacy of new drugs is evaluated with reference to anticipated response rates. Establishment of the microbial etiology of respiratory tract infections is hampered by the presence of "normal flora" of the nose, mouth, and pharynx, which may include asymptomatic carriage of potential pathogens. This issue is addressed for each category of infection described. For example, it is suggested that for initial phase 2 trials of acute otitis media and acute sinusitis tympanocentesis or direct sinus puncture be used to collect exudate for culture. Acute exacerbations of chronic bronchitis also present difficulties in the establishment of microbial etiology. These guidelines suggest that clinical trials employ an active control drug but leave open the possibility of a placebo-controlled trial. For pneumonia, the guidelines suggest the identification and enrollment of patients by the clinical type of pneumonia, e.g., atypical pneumonia or acute bacterial pneumonia, rather than by etiologic organism or according to whether it was community or hospital acquired. For each respiratory infection, the clinical response is judged as cure, failure, or indeterminate. Clinical improvement is not acceptable unless quantitative response measures can be applied.
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PMID:Evaluation of new anti-infective drugs for the treatment of respiratory tract infections. Infectious Diseases Society of America and the Food and Drug Administration. 147 53

An ongoing eight-country study is being conducted in an unprecedented number of general practice patients with acute upper and lower respiratory tract infections to compare the efficacy and tolerance of roxithromycin 150 mg b.i.d. for 7-14 days with the data acquired in the prelaunch studies of these same parameters. The target population is 40,000 (to be achieved by the end of 1991) and we report the interim results from 32,405 patients, 18,020 with upper and 14,385 with lower respiratory tract infections. In acute pharyngitis/tonsillitis sinusitis, and otitis, clinical resolution or improvement has been achieved in 97%, 96%, and 96% of cases, respectively. The figures for bronchitis, exacerbation of chronic bronchitis, and pneumonia are 97%, 94%, and 95%. Side effects have been reported in only 4% of patients to date, 75% consisting of moderate gastrointestinal upsets. Of the patients, 1% withdrew from treatment because of side effects. These interim figures confirm the data from the prelaunch, controlled comparative trials and show roxithromycin to be an appropriate choice of first-line antibiotic therapy in the management of respiratory tract infections in general practice.
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PMID:An international clinical trial on the efficacy and safety of roxithromycin in 40,000 patients with acute community-acquired respiratory tract infections. 161 29

Cefteram pivoxil (CFTM-PI), a new ester type cephem antibiotic, was administered at a daily dose of 600 mg to 81 patients with respiratory infections. They included 4 cases of laryngopharyngitis, 5 cases of tonsillitis, 26 cases of acute bronchitis, 13 cases of pneumonia, 10 cases of chronic bronchitis, 1 case of diffuse panbronchiolitis, 14 cases of infected bronchiectasis and 8 cases of infected other chronic respiratory diseases. Clinical effects were excellent in 18 cases, good in 50 cases, fair in 7 cases, and poor in 6 cases, thus, the efficacy rate was 84.0%. Nausea was observed in 2 cases, and diarrhea, vertigo, or fever was observed in 1 case each. The elevation of GOT and GPT values were found in 4 cases and a slight elevation of total bilirubin value was found in 1 case. These adverse reactions, however, were slight in their grades. CFTM-PI appears to be a useful oral cephem antibiotic in the treatment of respiratory infections.
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PMID:[Clinical studies on cefteram pivoxil in the treatment of respiratory infections]. 219 16

The efficacy of cefpodoxime proxetil has been studied in ten clinical trials conducted in adults suffering from lower respiratory tract infections (pneumonia, acute bronchitis or acute on chronic bronchitis) and upper respiratory tract infections (tonsillitis/pharyngitis or sinusitis). All the trials were controlled, randomized, multicentre and international and seven were double-blind, double-dummy designed. Over a period of 18 months from July 1988 to December 1989, 2448 patients were included. Among them, 2429 (99%) were evaluated for tolerance, 2101 (86%) for tolerance and clinical efficacy and 1018 (42%) for tolerance and clinical and bacteriological efficacy. The clinical response was judged satisfactory in 1205/1263 (95.4%) patients treated with cefpodoxime proxetil and in 788/838 (94%) patients treated with comparative antibiotics. The bacteriological response was judged satisfactory for 662/699 (95%) pathogens for cefpodoxime proxetil treatment versus 427/463 (92, 2%) for comparators. Cefpodoxime proxetil has been given to 7351 patients in the course of its international development with no severe side-effect being observed. Common reactions have been noted with a similar frequency to that seen with the other beta-lactams. No pseudomembranous colitis has been observed during clinical trials. On this basis, cefpodoxime proxetil appears to be efficacious and well tolerated and could be an antibiotic of first choice in the treatment of lower and upper respiratory tract infections in adults and adolescents.
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PMID:Cefpodoxime proxetil: dosage, efficacy and tolerance in adults suffering from respiratory tract infections. 229 35

Infectious pneumonias are inflammations of the lung that can be localized in the alveoli or interstitial tissue or both. The pathogenic agent is usually airborne; more rarely it is hematogenous. Important distinctions are between bacterial and nonbacterial forms, between diseases acquired outside and inside hospitals, and between patients who are basically healthy and those with a previous illness. Pneumococci continue to be the dominant pathogens outside hospitals. In hospitals, gram-negative, anaerobic, and fungal pathogens are more often found. Usually, purulent chronic bronchitis or an acute exacerbation of chronic bronchitis is based on a prior viral infection or an impairment of bacterial clearance mechanisms of the respiratory tract. The dominant pathogens are Haemophilus influenzae and pneumococci. Worldwide, viral infections of the upper respiratory tract have great epidemiological significance. With 12 different groups of viruses and more than 150 serotypes, there can be many causes of symptoms of rhinitis, tonsillitis, pharyngitis, laryngitis, and tracheitis as well as bronchitis.
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PMID:Respiratory infection: the disease. 407 65

Fundamental and clinical evaluation on ceftriaxone (Ro 13-9904, CTRX), a newly-developed injectable cephem antibiotic was performed as follows. The serum and urine concentrations of CTRX as well as the urinary recovery rate were determined in 7 children at 3 different dose levels; 3 cases administered with 10 mg/kg, 3 with 20 mg/kg and 1 with 48 mg/kg by one shot intravenous injection. The concentration in the cerebrospinal fluid was determined in 1 case of purulent meningitis associated with bacteremia, administered by one shot intravenous injection with 47.6 mg/kg. CTRX was also examined in its clinical and bacteriological efficacies by one shot intravenous injection for 8 days on average in a mean daily dose of 46.5 mg/kg, divided into twice a day in 31 cases, 3 times in 1 case, and 4 times changed from twice in 1 case; in a total of 33 children consisting of 3 with tonsillitis, 1 with chronic bronchitis, 20 with pneumonia, 2 with purulent meningitis associated with bacteremia, 3 with urinary tract infections, 1 with osteomyelitis associated with phlegmon, 3 with purulent lymphadenitis. The adverse reactions and laboratory test values were examined in a total of 40 cases, i.e., the above-mentioned 33 cases plus the 7 drop-out cases in which the clinical efficacy could not be evaluated. The results were as follows. The serum levels of CTRX in 7 cases consisting of 3 administered with 10 mg/kg, 3 with 20 mg/kg and 1 with 48 mg/kg reached their peaks 5 minutes after one shot intravenous injection and the mean values of them were 93.6 mcg/ml, 143.0 mcg/ml and 558.0 mcg/ml, respectively, indicating the existence of a dose-response among these groups, while the half-life times were 4.41, 5.86 and 4.09 hours. Among the 7 cases examined in the urinary levels as well as the serum levels, the 3 cases administered with 10 mg/kg reached the mean peak of 334.0 mcg/ml 2 to 4 hours after administration, while another 3 cases administered with 20 mg/kg showed peaks of 793.0, 522.0 and 536.0 mcg/ml, respectively, 2 to 4 hours, 4 to 6 hours and 6 to 12 hours after injection; this dispersion being partly because of that the urine specimen was unable to be collected regularly every hour in this dose group. In the case administered with 48 mg/kg, urinary level reached the highest value of 6,100.0 mcg/ml from 0 to 2 hours.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Fundamental and clinical evaluation of ceftriaxone in the pediatric field]. 609 8

The azalide antibacterial agent azithromycin is a semisynthetic acid-stable erythromycin derivative with an expanded spectrum of activity and improved tissue pharmacokinetic characteristics relative to erythromycin. The drug is noted for its activity against some Gram-negative organisms associated with respiratory tract infections, particularly Haemophilus influenzae. Azithromycin has similar activity to other macrolides against Streptococcus pneumoniae and Moraxella catarrhalis, and is active against atypical pathogens such as Legionella pneumophila, Chlamydia pneumoniae and Mycoplasma pneumoniae. Once-daily administration of azithromycin is made possible by the long elimination half-life of the drug from tissue. Azithromycin is rapidly and highly concentrated in a number of cell types after absorption, including leucocytes, monocytes and macrophages. It undergoes extensive distribution into tissue, from where it is subsequently eliminated slowly. A 3-day oral regimen of once-daily azithromycin has been shown to be as effective as 5- to 10-day courses of other more frequently administered antibacterial agents [such as erythromycin, amoxicillin-clavulanic acid and phenoxymethylpenicillin (penicillin V)] in patients with acute exacerbations of chronic bronchitis, pneumonia, sinusitis, pharyngitis, tonsillitis and otitis media. Adverse effects of azithromycin are mainly gastrointestinal in nature and occur less frequently than with erythromycin. Azithromycin is likely to prove most useful as a 3-day regimen in the empirical management of respiratory tract infections in the community. Its ease of administration and 3-day duration of therapy, together with its good gastrointestinal tolerability, should optimise patient compliance (the highest level of which is achieved with once-daily regimens). Azithromycin is also likely to be useful in the hospital setting, particularly for outpatients and for those unable to tolerate erythromycin.
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PMID:Azithromycin. A review of its pharmacological properties and use as 3-day therapy in respiratory tract infections. 888 83

Infections of the upper airways reduce life quality of adults on average twice, that of children even 4 to 8 times a year. Usually these are viral infections subsiding spontaneously without antibiotics. Only if concomittant circumstances arise and in specific clinical situations (otitis, sinusitis, tonsillitis, epiglottitis) as well as in acute exacerbation of chronic bronchitis are antibiotics already indicated at first consultation. The physician who is usually consulted by a patient with increasing discomfort under self-medication and who is expecting an antibiotic treatment has next to the clinical findings and prior laboratory test results to consider before all the individual (home, workplace, school) and epidemiologic (influenza) situation, the possible pathogens, their susceptibility to antibiotics as well as the side effects and costs for the decision to prescribe antibiotics. Today because of an increasing pressure of selection for pathogens resistant to antibiotics a greater reluctance to prescribe antibiotics is recommended. This requires close follow-up of the patient with symptomatic treatment or only short "probatory" antibiotic therapy and a good patient-physician relationship.
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PMID:[When and why are antibiotics indicated in airway infections (except pneumonia)?]. 924 62


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