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Biomedical subjects

J Dunlay

Publications and source records attributed to J Dunlay.

5 recordsLinked to original sources

A placebo-controlled, double-blind trial of erythromycin in adults with acute bronchitis.

Sixty-three otherwise healthy adults with acute productive cough and no clinical evidence of pneumonia were randomized to receive a ten-day course of erythromycin or placebo. Fifty-seven of these patients returned completed symptom diaries or returned for a two-week follow-up visit. Patients treated with erythromycin reported a more rapid improvement in subjective ratings of cold symptoms, general health, sputum production, and a mean symptom score. Fewer patients in the erythromycin group required cough or cold medications or were congested by day 10 (P less than .05). The treatment group was also less likely to have purulent sputum (9 percent vs 36 percent, P less than .05) and abnormal lung examinations (0 percent vs 29 percent, P less than .01) at a two-week follow-up visit. These results support the use of erythromycin in acute bronchitis.

Acute Disease

Pyomyositis.

Pyomyositis is a bacterial infection of skeletal muscle that is usually accompanied by abscess formation. Staphylococcus aureus is the most common causative organism. Pyomyositis should be suspected in any patient who presents with fever, muscle pain and leukocytosis. It is confirmed by needle aspiration and culture of the suspected muscle group. Treatment entails incision and drainage of abscesses and appropriate antibiotic therapy.

Adolescent

Clinical features and treatment of acute bronchitis.

Although several surveys rank acute bronchitis as one of the ten most frequent diagnoses made by primary care physicians, its clinical features are poorly defined and treatment with antibiotics is controversial. This study was designed to determine the clinical characteristics that providers use to diagnose acute bronchitis and to examine the use of antibiotics in treating this illness. Charts of patients with the diagnosis of acute bronchitis or upper respiratory tract infection (URI) were randomly selected and progress notes from these visits were reviewed. Signs, symptoms, laboratory tests, and antibiotics prescribed were recorded. Patients with a diagnosis of acute bronchitis had more productive cough, purulent sputum, and abnormal lung examinations than patients with a diagnosis of URI (P less than .05 for each characteristic). Laboratory tests, including chest roentgenograms, were not frequently used in making the diagnosis of acute bronchitis. Antibotics were prescribed for 27 of 29 patients (92 percent) with a diagnosis of acute bronchitis but for only 4 of 19 patients (21 percent) with a diagnosis of URI. Erythromycin was prescribed for 60 percent of patients with acute bronchitis. From this study it can be concluded that providers use the term acute bronchitis to designate a specific clinical syndrome that they treat with antibiotics. Further clinical trials are needed to evaluate the efficacy of such antibiotic therapy.

Acute Disease