Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: UMLS:C0348321 (Haemophilus)
15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-five consecutive eligible adult patients, who were treated as outpatients for stable severe-to-very severe COPD, were enrolled in the study. All of them received 23-valent pneumococcal capsular polysaccharide vaccine intramuscularly. Patients were seen monthly, as well as whenever they had symptoms suggestive of an exacerbation, at our outpatient clinic. Eighteen out of 65 patients suffered from acute exacerbation (AECOPD). Three of these patients presented two episodes of AECOPD. Patients with an acute exacerbation of COPD received azithromycin 500 mg/day once daily for 3 days and a short course of oral prednisolone 25 mg/die. In 16 cases, a single species was isolated, while in the remaining 5 cases at least two species were recovered. Clinical cure or improvement at the end of therapy (3-5 days post-therapy) was reported in 17 episodes of AECOPD with no relapse at the late post-therapy (10-14 days after the completion of treatment). Bacteriologic eradication or presumptive eradication rates at the end of therapy were 86% (24 out of 28 isolates). Azithromycin eradicated all isolates of Haemophilus influenzae, Moraxella catarrhalis, H. parainfluenzae, Klebsiella pneumoniae, and Klebsiella spp. isolated at baseline. Eradication of Sta aureus occurred in 1 of 3 isolates whereas azithromycin was unable to eradicate Pseudomonas aeruginosa isolates. Our data seem to indicate that pneumococcal vaccination reduces the possibility that an AECOPD is caused by Streptococcus pneumoniae. This finding allows the use of antibiotics such as azithromycin, which, otherwise, should be avoided because of resistances.
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PMID:Treatment of acute exacerbation of severe-to-very severe COPD with azithromycin in patients vaccinated against Streptococcus pneumoniae. 1587 82

Azithromycin is an azalide with in vitro activity against otitis media pathogens, good middle ear penetration and a prolonged half-life. A total of four clinical trials have evaluated the clinical success rate, safety and compliance of single-dose azithromycin (30 mg/kg) in the treatment of children with otitis media. Among all the patients treated with single-dose azithromycin (30 mg/kg), and presented previously in four published clinical trials, end-of-treatment clinical success was 88% (544 out of 619) and maintained clinical success at the end-of-study was 82% (498 out of 610). Three of the four studies included a mandatory baseline tympanocentesis. The overall end-of-treatment and end-of-study clinical success rates among all culture-positive patients was 84% (222 out of 263) and 80% (210 out of 263), respectively. Per pathogen end-of-treatment clinical success rates observed were 91% (125 out of 137) among patients with Streptococcus pneumoniae, 77% (75 out of 97) among patients with Haemophilus influenzae, 100% (14 out of 14) among patients with Moraxella catarrhalis, 64% (seven out of 11) among patients with baseline Streptococcus pyogenes and 25% (one out of four) among patients with a S. pneumoniae and H. influenzae mixed infection. Clinical success was observed in 90% (106 out of 118) of patients with baseline macrolide-susceptible S. pneumoniae and in 67% (14 out of 21) among patients with baseline macrolide-resistant S. pneumoniae (p = 0.01). Adverse events were uncommon, mostly mild and transitory gastrointestinal complaints, and in the two larger comparative trials, were less frequent than the rates observed with the comparator agents. Compliance was excellent (99-100%). Single-dose azithromycin (30 mg/kg) represents an alternative for the treatment of pediatric patients with uncomplicated acute otitis media, particularly in those geographic regions where high-level S. pneumoniae macrolide resistance is uncommon, and for those patients that require directly observed therapy or when compliance may be a problem.
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PMID:Single-dose azithromycin for the treatment of children with acute otitis media. 1620 62

Ceftobiprole, a broad-spectrum pyrrolidinone-3-ylidenemethyl cephem currently in phase III clinical trials, had MICs between 0.008 microg/ml and 8.0 microg/ml for 321 clinical isolates of Haemophilus influenzae and between < or =0.004 microg/ml and 1.0 microg/ml for 49 clinical isolates of Moraxella catarrhalis. Ceftobiprole MIC(50) and MIC(90) values for H. influenzae were 0.06 microg/ml and 0.25 microg/ml for beta-lactamase-positive strains (n = 262), 0.03 microg/ml and 0.25 microg/ml for beta-lactamase-negative strains (n = 40), and 0.5 microg/ml and 2.0 microg/ml for beta-lactamase-negative ampicillin-resistant strains (n = 19), respectively. Ceftobiprole MIC(50) and MIC(90) values for beta-lactamase-positive M. catarrhalis strains (n = 40) were 0.12 microg/ml and 0.5 microg/ml, respectively, whereas the ceftobiprole MIC range for beta-lactamase-negative M. catarrhalis strains (n = 9) was < or =0.004 to 0.03 microg/ml. Ceftriaxone MICs usually were generally at least twofold lower than those of ceftobiprole, whereas amoxicillin-clavulanate MICs usually were higher than those of ceftobiprole. Azithromycin and telithromycin had unimodal MIC distributions against H. influenzae, with MIC(90) values of azithromycin and telithromycin of 2 microg/ml and 4 microg/ml, respectively. Except for selected quinolone-nonsusceptible H. influenzae strains, moxifloxacin proved highly active, with MIC(90) values of 0.12 microg/ml. Time-kill analyses showed that ceftobiprole, ceftriaxone, cefpodoxime, amoxicillin-clavulanate, azithromycin, telithromycin, and moxifloxacin were bactericidal at 2x MIC by 24 h against all 10 H. influenzae strains surveyed. Only modest increases in MICs were found for H. influenzae or M. catarrhalis clones after 50 serial passages in the presence of subinhibitory concentrations of ceftobiprole, and single-passage selection showed that the selection frequency of H. influenzae or M. catarrhalis clones with elevated ceftobiprole MICs is quite low.
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PMID:Activities of ceftobiprole, a novel broad-spectrum cephalosporin, against Haemophilus influenzae and Moraxella catarrhalis. 1672 65

The bacterial time-kill curves of azithromycin against four bacterial strains (Streptococcus pneumoniae/penicillin-intermediate, S. pneumoniae/penicillin-sensitive, Haemophilus influenzae and Moraxella catarrhalis) were determined by in vitro infection models. Eighteen different pharmacokinetic/pharmacodynamic models were fitted to the time-kill data using non-linear regression and compared for best fit. A simple, widely used E(max) model was not sufficient to describe the pharmacodynamic effects for the four bacterial strains. Appropriate models that gave good curve fits included additional terms for saturation of the number of bacteria (N(max)), delay in the initial bacterial growth phase and/or the onset of anti-infective activity (1-exp(-zt)) as well as a Hill factor (h) that captures the steepness of the concentration-response profile. Azithromycin was highly effective against S. pneumoniae strains and M. catarrhalis while the efficacy against H. influenzae was poor. Applications of these pharmacokinetic/pharmacodynamic models will eventually provide a tool for rational antibiotic dosing regimen decisions.
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PMID:Pharmacokinetic/pharmacodynamic modeling of in vitro activity of azithromycin against four different bacterial strains. 1719 70

Resistant clones/phenotypes are putting into question the activity of commonly used beta-lactams, thus prompting the need for alternative options. A 500 mg levofloxacin vs. azithromycin once daily pharmacodynamic simulation was performed against 10(8) cfu/ml of four Streptococcus pneumoniae strains (exhibiting higher amoxicillin than penicillin MIC) and four Haemophilus influenzae strains: beta-lactamase producing, BLNAR (beta-lactamase-negative ampicillin-resistant) and BLPACR (beta-lactamase-positive amoxicillin/clavulanate-resistant). High levofloxacin AUC/MIC values for H. influenzae, and values of 50-100 for S. pneumoniae produced a >5 log(10) reduction at 24h for all strains. Azithromycin AUC/MIC values of approximately 10 were needed to obtain a 2-3 log(10) reduction of S. pneumoniae initial inocula, but lower AUC/MIC values (of approximately 6) obtained > or =3 log(10) reduction against all strains of H. influenzae. While in vitro simulated serum concentrations of levofloxacin were bactericidal at the end of the dosing interval against all S. pneumoniae strains and azithromycin against the susceptible ones, both antimicrobials achieved this endpoint against the BLNAR and BLPACR strains.
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PMID:Levofloxacin vs. azithromycin pharmacodynamic activity against S. pneumoniae and H. influenzae with decreased susceptibility to amoxicillin/clavulanic acid. 1823 May 48

The azalide azithromycin, which is derived from erythromycin, contains a methyl-substituted nitrogen in the lactone ring. This 15-membered expanded lactone ring results in improved acid stability and oral bioavailability compared with erythromycin. Azithromycin possesses a broad spectrum of activity against Gram-positive and Gram-negative bacteria, including enhanced activity compared with the macrolides against Haemophilus influenzae and Moraxella catarrhalis. In vitro activity of azithromycin against intracellular and clinically atypical pathogens is also good. Azithromycin has a distinct pharmacokinetic profile compared with other antimicrobial agents, the most prominent feature is its high tissue selectivity. Concentrations of azithromycin in respiratory tract, gynaecological tissue and prostate remain above minimum inhibitory concentrations of pathogens for several days, thus making it possible to use a short-course, once-daily dosing regimen. Another feature of azithromycin is that it rapidly penetrates phagocytic cells, with the release of the antibiotics at local sites of infection. Comparative clinical trials have shown that azithromycin given once daily for 3 or 5 days is comparable to comparator drugs given for 7 or 10 days in the treatment of otitis media, sinusitis, pharyngitis, acute bronchitis, acute infectious exacerbations of chronic bronchitis, community-acquired pneumonia and skin and soft tissue infections in adults. Azithromycin given once daily for 3 days has also been shown to be effective in the treatment of respiratory tract and skin and soft tissue infections in children. In addition, some sexually-transmitted diseases are effectively treated by a single 1-g dose of azithromycin; clinical and microbiological responses were comparable to those recorded using doxycycline given twice daily for 7 days. The short-duration, once-daily dosing regimen is well tolerated in adults and children, and there is no evidence of interaction between azithromycin and theophylline, terfenadine, or cimetidine.
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PMID:Azithromycin: the first of the tissue-selective azalides. 1861 63

Azithromycin and clarithromycin are both highly active in vitro against Gram-positive respiratory pathogens, but azithromycin is substantially more potent against Haemophilus influenzae. We investigated the susceptibility of H. influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and S. pyogenes to azithromycin and clarithromycin, and determined the prevalence of beta-lactamase production in H. influenzae and M. catarrhalis. Results from three geographic regions of the USA were compared. A significantly greater proportion of H. influenzae isolates were susceptible to azithromycin than to clarithromycin (95.7% vs 63.1%, P < 0.001). M. catarrhalis, S. pneumoniae and S. pyogenes were highly susceptible to both antibiotics with no significant differences in susceptibility. beta-Lactamase was produced by 94.8% of M. catarrhalis isolates and 35.6% of H. influenzae.
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PMID:Susceptibility surveillance of U.S. respiratory pathogen isolates to newer macrolide and azalide antibiotics. 1861 36

Recent macrolide derivatives, roxithromycin, azithromycin and clarithromycin show more favourable pharmacokinetic characteristics in comparison to old ones and some differences in antibacterial activity. With the aim of improving our understanding of some aspects of their action against respiratory pathogens, we determined the MICs and MBCs of Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Moraxella catarrhalis and Haemophilus influenzae. Azithromycin was the most active agent against Haemophilus influenzae and Moraxella catarrhalis, while clarithromycin was more active against Streptococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus with MICs similar to those of erythromycin. The bactericidal activity of all tested derivatives was weak against Staphylococcus aureus (MBC/MIC ratio approximately 16) and against Moraxella catarrhalis (MBC/MIC ratio, 8-16), but good against Staphylococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae (MBC/MIC ratio, 2-4). The determination of killing curves in the presence of 2 MIC and 10 MIC of azithromycin, clarithromycin and roxithromycin confirmed their weak bactericidal activity against Staphylococcus aureus and Moraxella catarrhalis as well as their effective activity against Streptococcus pyogenes and Streptococcus pneumoniae. Azithromycin showed the highest bactericidal activity against Haemophilus influenzae. As expected, the three derivatives produced a quite prolonged PAE when exposed to 5 MIC for 1 h, ranging between 2-4 h. The bactericidal activity and the prolonged PAE of new macrolides for the most common respiratory pathogens should assure a good clinical activity in respiratory infections including those sustained by Haemophilus influenzae, which is less susceptible to erythromycin and other old macrolides.
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PMID:Comparative antimicrobial activity and post-antibiotic effect of azithromycin, clarithromycin and roxithromycin against some respiratory pathogens. 1861 54

Azithromycin (AZM) is widely used for respiratory tract infections and otitis media because of its activity against Haemophilus influenzae and atypical pathogens, and its ease of administration. Although leukopenia is the one of the most frequent AZM-related laboratory abnormalities in children, agranulocytosis has not been reported in adults. Here, we present the case of an 81-year-old man with agranulocytosis following AZM-treatment for acute otitis media. He developed febrile neutropenia and granulocyte colony-stimulating factor and cefepim were administered. All his symptoms and absolute neutrophil counts were recovered within 7 days after admission. Physicians must be vigilant in identifying drug-induced neutropenia in AZM-treated patients because early detection can decrease the severity and prevent mortality.
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PMID:Azithromycin-related agranulocytosis in an elderly man with acute otitis media. 1952 5

Conjunctivitis, or inflammation of the conjunctiva, refers to a diverse group of ocular surface diseases of viral or bacterial origin that primarily affect the conjunctiva. In developed countries, the most common causative bacterial pathogens are Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae. Most varieties of conjunctivitis are self-limiting; however, some cases can be extremely contagious or cause serious complications if left unchecked. New ocular antibiotics are needed to keep pace with the increasing incidence of bacterial resistance and provide options that decrease the overall treatment burden and encourage patient compliance. Azithromycin is a well known systemic anti-infective with broad spectrum activity against gram positive-, gram negative-, and atypical bacteria species. Ocular use has been limited because its solubility and stability profiles in aqueous media were not favorable for delivery to the eye. An eyedrop of 1% azithromycin in DuraSite((R)) (AzaSite, InSite Vision, Alameda, CA, USA), a bioadhesive ocular drug delivery system, was recently developed and evaluated in clinical trials. This formulation is well tolerated, delivers a high concentration of azithromycin to the conjunctiva, has a broader eradication profile than aqueous azithromycin, and can be effectively dosed with 7 drops, a 65% reduction in the amount of drops required by the most popular antibiotics currently used for conjunctivitis.
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PMID:Clinical development of 1% azithromycin in DuraSite, a topical azalide anti-infective for ocular surface therapy. 1966 61


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