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Query: UMLS:C0149514 (bronchitis)
 6,902 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mycoplasma pneumoniae was the most frequently proved causative agent of pneumonia in patients hospitalized in our hospital. During the 6-year period (1980-1985), Mycoplasma pneumoniae was diagnosed in 390 patients with acute respiratory infections. Out of them 315 had pneumonia, and 75 had acute bronchitis with febrility. Pneumonia of older children and of younger adults was caused by Mycoplasma pneumoniae mostly. Most of our patients (60.77%) were treated by inadequate antibiotic therapy. In 176 (45.13%) the therapy with mostly inappropriate antibiotic started before hospitalization. This was the main reason why 165 patients (42.31%) were given two or more antibiotics. Only 126 patients (32.31%) were treated rationally with one antibiotic from the group of tetracyclines or macrolides. Doxycycline was the most effective drug, and erythromycin and midecamycin showed the very good result as well. The difference among these three antibiotics was not statistically significant (x2 = 3.188; p greater than 0.05). However, this difference was statistically very significant in relation to penicillin (x2 = 28.082; p less than 0.001). Penicillin was given to 62 patients (15.90%).
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PMID:[Critical analysis of antibiotic therapy of acute respiratory infections caused by Mycoplasma pneumoniae]. 250 37

The comparative efficacy of doxycycline versus amoxicillin, cephalexin, cefaclor and enoxacin was examined in four separate cross-over and blinded studies of acute bacterial bronchitis in chronic bronchitis and asthma. The efficacy of doxycycline over the eleven-year period (1975-1986) covered by these studies also was examined. Patients with acute bacterial exacerbations, defined by increased chest symptoms, increased bacteria and sputum neutrophilia, were randomly entered. When a new acute infection occurred, they were re-entered and received the other antibacterial. Response was recorded as successful or not; early rebound infections and the periods free of infection were noted. A total of 136 exacerbations were evaluated in the comparison of doxycycline with the other 4 antibacterials, and 93 exacerbations in the long-term efficacy of doxycycline. The acute success was similar for doxycycline with the other antibacterials and was superior to cefaclor. Early rebound infections occurred less frequently with doxycycline as compared to the cephalosporins and was similar versus amoxicillin and enoxacin. The infection-free period was longer after doxycycline than with the other four antimicrobials. Doxycycline maintained its efficacy to elicit a prompt response and provide a long infection-free period, but an increase of early rebound infections was noted over the eleven-year period.
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PMID:Comparative trials of doxycycline versus amoxicillin, cephalexin and enoxacin in bacterial infections in chronic bronchitis and asthma. 304 55

Acute bronchitis is a common reason for visits to primary care physicians and a commonly given reason for antibiotic treatment. However, evidence regarding the efficacy of antibiotics for this syndrome is lacking. In a randomized trial, a one-week course of a frequently used antibiotic, doxycycline, was compared with one week of placebo in 74 otherwise healthy adults with acute bronchitis. The doxycycline group fared no better than the placebo group for all 13 outcomes measured, including duration of cough, clinical improvement at one week, return visits for unresolved symptoms, days away from work, and subjective ratings of cough severity, sleep loss, diminished activity and overall well-being. Doxycycline is not beneficial in the treatment of acute bronchitis in otherwise healthy adults.
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PMID:A randomized, controlled trial of doxycycline in the treatment of acute bronchitis. 638 19

The Stichting Werkgroep Antibioticabeleid (SWAB, Foundation Antibiotics Policy Team) has issued guidelines for empirical antimicrobial therapy of adult patients with bronchitis in hospital. Acute bronchitis is rarely caused by bacteria: therefore antibiotic treatment is not indicated in most cases. In an exacerbation of asthma or chronic obstructive pulmonary disease (COPD), the primary treatment aims at combating the inflammatory reaction and the bronchospasm. In case of increasing dyspnoea, (increase of) sputum production and (increase of) purulence of the sputum, antibiotic treatment may lead to shortening of the symptoms and sickness duration. Doxycycline is to be preferred because of its spectrum, easy dosage and favourable price. If the patient has not had antibiotics earlier, amoxicillin also is a good choice. Macrolide antibiotics are no preparations of first choice because large-scale use readily leads to resistance.
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PMID:[Optimizing of antibiotics policy in the Netherlands. III. SWAB guidelines for antimicrobial therapy in adults hospitalized with bronchitis. Foundation Antibiotics Policy Work Group]. 1002 39

Chlamydia psittaci and Chlamydia pneumoniae are important causes of community-acquired pneumonias. Less commonly, C. trachomatis may cause pneumonia in adult immunocompromised hosts but more commonly is responsible for pneumonia in neonates. C. psittaci is the cause of psittacosis and is the only chlamydial zoonotic atypical pneumonia. C. pneumoniae is being increasingly recognized as the cause of up to 10% of community-acquired pneumonias. C. pneumoniae pneumonia has a clinical presentation like Mycoplasma pneumoniae pneumonia. C. pneumoniae is also responsible for a variety of other respiratory tract infections, e.g., sinusitis, bronchitis, otitis, pharyngitis and laryngitis. C. pneumoniae, like M. pneumoniae, may result in permanent airway disease, e.g., asthma, following infection. All chlamydia are sensitive to doxycycline. Macrolides are highly active against C. trachomatis, and in spite of in vitro susceptibility, are relatively inactive in vivo against C. psittaci and C. pneumoniae. Fluoroquinolones are also active against chlamydia. Doxycycline remains the preferred antibiotic to treat all chlamydial infections in nonpregnant adults.
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PMID:The chlamydial pneumonias. 1474 68

Certain antibiotics possess anti-inflammatory properties and could potentially be used to treat inflammatory lung diseases associated with an influx of monocytes such as panbronchiolitis, asthma, cystic fibrosis, and bronchitis. Doxycycline is reported to possess anti-inflammatory effects. Monocyte chemoattractant protein-1 (MCP-1) is a major inflammatory cytokine and a powerful chemoattractant for monocytes. The authors hypothesized that doxycycline exerts its anti-inflammatory effects, in part, by reducing MCP-1 production. To test this hypothesis, A549 human lung epithelial cells were stimulated with cytomix in the presence or absence of doxycycline. In stimulated cells doxycycline decreased MCP-1 production by 95% and in monocyte chemotaxis assays migration decreased by 55%. However, doxycycline did decrease expression of MCP-1 mRNA and did not effect its stability. These data demonstrate that doxycycline modulates MCP-1 production and suggest that doxycycline may provide a new anti-inflammatory therapy for chronic lung diseases.
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PMID:Doxycycline decreases monocyte chemoattractant protein-1 in human lung epithelial cells. 1680 18

Ureaplasma urealyticum is a commensal of the female genital tract and can be detected as a pathogen in urethritis and vaginitis. Its importance as a respiratory pathogen beyond the field of neonatology remains controversial. We report a case of Ureaplasma-pneumonia in a recently lung-transplanted patient, with hyperammonemic syndrome. The 51-year-old lung-transplanted female was admitted to the intensive care unit with new-onset reduction of her mental state due to hyperammonemia. A diagnostic bronchoscopy showed purulent bronchitis and multiple superficial ulcerations of the bronchial mucosa. The DNA-PCR from bronchoalveolar lavage confirmed the presence of Ureaplasma urealyticum in low concentration (about 5 * 104 copies/ml), which was interpreted as evidence of infection and treated with Doxycycline intravenously. Ureaplasma was also identified by DNA-PCR in the biopsy specimens of the inflammatory enlarged mediastinal lymph nodes. Bilateral pleural effusions were found to be transudative and culturally sterile. Ureaplasma-pneumonia can cause fatal hyperammonemia in lung-transplant patients and should be considered in the differential diagnosis of every unclear hyperammonemia with normal liver function. The early identification and treatment of the infection leads to clinical and biochemical resolution.
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PMID:Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation. 3242 20