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PubMed1991

[Clinical and pharmacokinetics studies of ceftriaxone upon 2g once daily administration in respiratory tract infections].

Clinical studies on ceftriaxone (CTRX) were conducted with 2 g once daily administration to respiratory tract infections. In addition, CTRX concentrations in serum, sputum and urine were determined. The results obtained are summarized as follows: 1. Clinical responses to CTRX in a total of 29 cases with respiratory tract infections were excellent in 7 cases, good in 13, fair in 8 and poor in 1 with a response rate of 69.0%. 2. CTRX concentrations in serum, sputum and urine (total and free body) were determined in 3 cases after intravenous drip infusion of 2g CTRX. Peak levels in sputum were 2.6 to 7.8 micrograms/ml, and CTRX maintained high sputum levels for 12 to 24 hours after administration.

Aged↗
PubMed1991

Should you cancel the operation when a child has an upper respiratory tract infection?

Cancelling an operation when a child has an upper respiratory tract infection (URI) is not always feasible or practical. Yet we know very little about the additional risk posed by a URI occurring in a child undergoing anesthesia and surgery. Using a large prospectively collected pediatric anesthesia database, we studied 1283 children with a preoperative URI and 20,876 children without a URI. We found that children with a URI were two to seven times more likely to experience respiratory-related adverse events during the intraoperative, recovery room, and postoperative phases of their operative experience. Although these children also experienced significant disruptions in temperature regulation, they were not at risk for any other deleterious events. The elevation in risk after URI as compared with children without a URI was not explained by differences in age, physical status scores, surgical site, and emergency or elective status. However, if a child had a URI and had endotracheal anesthesia, the risk of a respiratory complication increased 11-fold (95% confidence intervals 6.8, 18.1). We conclude that the administration of general anesthesia to children with a URI is not benign and that these children require more observation/management in all perioperative phases of their surgical procedure.

Anesthesia, General↗
PubMed1984

Broad spectrum oral amoxycillin in acute respiratory tract infections.

The clinical outcome of 143 patients presenting with acute respiratory tract infection and treated with oral amoxycillin is described. A clinical success rate of 92% was observed after 1 week's therapy with only one patient deteriorating whilst on treatment. Side-effects were mild and limited to 7% of patients.

Acute Disease↗
PubMed1994

[Antibacterial activities of cefetamet against clinically isolated strains from community acquired respiratory tract infections (II)].

Antibacterial activities of cefetamet (CEMT) against clinically isolated strains from patients with community acquired respiratory tract infections were compared to those of other oral beta-lactam antibiotics in the period from January to March 1994. The following results were obtained. 1. CEMT showed strong antibacterial activities against three major pathogens causing community acquired respiratory tract infections, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae. However, antibacterial activities of CEMT against benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) and PCG-resistant S. pneumoniae (PRSP) were slightly weaker than of those of some the reference antibiotics. 2. No MIC value changes of CEMT were observed from year to year against Moraxella subgenus Branhamella catarrhalis and Klebsiella pneumoniae.

Bacteria↗
PubMed1982

[Studies on 9,3"-diacetylmidecamycin dry syrup in pediatric acute respiratory tract infections (author's transl)].

The authors have carried out some studies on MOM dry syrup in the field of pediatrics and the results were as follows. 1. After oral administration of MOM at 20 mg/kg, the serum level peaked at 30 minutes and MOM could still be detected in the serum at up to 4 hours. The half-life was 0.67 hour. The urinary recovery rate of MOM was 1.43% up to 6 hours after this oral administration. 2. The clinical efficacy rates with MOM continuous treatment at a daily dose of 19.4 to 50.0 mg/kg (almost about 30 mg/kg) were 85.7% for upper respiratory tract infections, 66.7% for lower respiratory tract infections and 95.7% for Mycoplasma pneumonia. 3. It was easy to administer MOM orally even to the younger children. Although MOM was administered for 4 to 21 days, no side effects were observed locally or systemically except for transient slight diarrhea. These results confirmed the usefulness of MOM in the treatment of acute respiratory tract infections in children.

Administration, Oral↗
PubMed1988

Depression after each respiratory tract infection in an adolescent girl.

Recurrent episodes of depression accompanied by mild hypersomnia after each respiratory tract infection in an adolescent girl, 10 years old at the first onset, are described. Each episode lasted about 1 week, and she had 11 such episodes up to the age of 14 years, when lithium was prescribed. While on lithium, she suffered three times from febrile and once from afebrile upper respiratory tract infection, but these episodes were not followed by depression or hypersomnia.

Adolescent↗
PubMed1989

[Controlled multicentric study comparing cefixime and amoxicillin in the treatment of lower respiratory tract infections in adults].

This multicentre, randomized, double-blind study evaluated the effectiveness and safety of cefixime versus amoxicillin. Patients were admitted if they had lower respiratory tract infection with a bacterial pathogen susceptible to both study drugs. Diagnoses included acute respiratory tract infections with no underlying pulmonary pathology (cefixime 21, amoxicillin 27), acute exacerbation of chronic obstructive lung disease (cefixime 32, amoxicillin 42), superinfection of viral bronchitis or lung cancer, and pleuritis (cefixime 10, amoxicillin 6). Patients were treated for at least 10 days with either cefixime 200 mg b.d. or amoxicillin 1 g b.d. A clinical success rate of 80.7 per cent (50/62) in the cefixime group and 82.2 per cent (60/73) in the amoxicillin group was achieved in infections due to susceptible organisms. In acute infections with no underlying pathology, the clinical success rate was 90.5 per cent with cefixime and 81.5 per cent with amoxicillin. Twenty-three cefixime patients and 20 amoxicillin patients were seen 2 to 6 weeks after treatment: there were 2 and 1 clinical recurrences, respectively. All 3 patients were suffering from chronic obstructive lung disease. The bacteriological eradication rate at the end of treatment in assessable patients was 94.7 per cent (17/18) with cefixime and 80 per cent (16/20) with amoxicillin. Six and 11 new organisms appeared, responsible for 2 superinfections under cefixime and 7 under amoxicillin. Treatment was well tolerated by 96.4 per cent of cefixime patients and 90 per cent of amoxicillin patients. This study confirms the value of cefixime as a new oral antibiotic in the treatment of lower respiratory tract infections in adults.

Adolescent↗
PubMed1993

Prospective study of aetiology and outcome of adult lower-respiratory-tract infections in the community.

Community-acquired adult lower-respiratory-tract infections (LRTI) are generally thought to be caused by atypical and viral infections. We have studied 480 adults presenting to a single general practice with community-acquired LRTI between November, 1990, and December, 1991. The overall incidence was 44 cases per 1000 population per year; the incidence was 2-4 times higher in people aged 60 and over than in those aged less than 50. 206 patients were studied in detail; among this group 91 (44%) had 113 pathogens identified. There were 92 bacteria (Streptococcus pneumoniae in 62 and Haemophilus influenzae in 16), 19 viruses (influenza virus in 12), and only 2 atypical pathogens (Mycoplasma pneumoniae and Coxiella burnetii). Pneumococcal infection was common in people who were 60 or older, those who had underlying chronic disease, or people with both features. There was moderate morbidity in terms of time in bed, time to return to normal activities, and days off work. 25% of patients returned for a second consultation with the general practitioner, in most because of unsatisfactory clinical progress. Community-acquired LRTI are very common, and the range of causative pathogens is similar to that for community-acquired pneumonia. Existing management strategies seem inadequate.

Adolescent↗
PubMed1996

Detection of Mycoplasma pneumoniae by two polymerase chain reactions and role of M. pneumoniae in acute respiratory tract infections in pediatric patients.

Mycoplasma pneumoniae and viruses in acute respiratory tract infections in children were studied during the winter of 1992-1993 in Antwerp, Belgium. M. pneumoniae was diagnosed in nasopharyngeal aspirates by culture and polymerase chain reaction (PCR). For this, amplification of a fragment of the PI adhesin gene in samples prepared by two methods was compared in two laboratories, and in one laboratory, a fragment of the 16S rRNA gene was amplified. The sensitivity of culture versus PCR was 61.5%. Provided a specific internal control is used, sample preparation by freeze-boiling combined with PCR for the PI gene and amplicon detection by visual inspection of the electrophoresis gel can be recommended, although maximal results are obtained after hybridization. M. pneumoniae was present in 0.5% of patients <2 years old and 6.9% of patients >2. M. pneumoniae was second to respiratory syncytial virus or detected equally in lower respiratory infections.

Adhesins, Bacterial↗
PubMedDate not supplied

Acute lower respiratory tract infection due to virus among hospitalized children in Dhaka, Bangladesh.

The nature of acute lower respiratory tract infection (ALRI) in hospitalized children and of the associated viral agents was assessed in a study of 601 children less than 5 years old over a 24-month period. Of these children, 80% were less than 24 months of age and the ratio of boys to girls was 1.7:1. Pneumonia (86.5% of cases) was the most frequently observed clinical manifestation. Shedding of virus was detected in 21.1% of the children; the highest rate occurred in infants 0-5 months old (27%) as compared with a rate of only 12.5% in children 25-60 months old. Virus was detected in 33.3%, 32.8%, 21.2%, and 20% of the cases of tracheobronchitis, bronchiolitis, pneumonia, and croup, respectively. Among the viruses detected, 78% were respiratory syncytial virus (RSV) (91% of infections with this virus occurred in children less than 2 years old) and 14.4% were influenza virus types A and B. Of the RSV infections, 61% occurred in infants less than 1 year old. The case-fatality rate was 6.8% overall and was 4.8% in virus-associated cases. No consistent pattern of seasonal occurrence of viral infections was discerned. RSV was detected throughout the year, with increased prevalence from January to April.

Acute Disease↗
PubMed2002

No advantage of treating acute respiratory tract infections with azithromycin in a placebo-controlled study.

Acute respiratory tract infection (ARTI) is the commonest reason for which antibiotics are prescribed, despite the fact that ARTI is mostly of viral origin. The effectiveness of antibiotics in these illnesses is, at best, questionable. Jordan is a developing country where bacterial infections are thought to be more common than in developed countries and initially viral illnesses are frequently superimposed by bacterial infections. The present study represents an attempt to assess whether routine antibiotic treatment of ARTI has any beneficial effect on the course of the illness. The study was conducted in northern Jordan between 1 June and December 14, 2000. Patients > or =8 y of age visiting either of 2 health centers and diagnosed by the physician with ARTI above the level of the bronchioles were assigned on an alternating basis to receive either azithromycin or placebo. Patients were assessed at their initial visit and were subsequently followed up after 3 d, 1 week and 2 weeks. A total of 185 patients were included in the study. Patients administered azithromycin or placebo did similarly in terms of the proportions improved or cured and the duration of illness. We conclude that routine use of antibiotics (azithromycin) in ARTI is unlikely to alter the course of the illness.

Acute Disease↗
PubMed2000

Perioperative considerations for the child with an upper respiratory tract infection.

The decision to cancel or proceed with elective surgery for the child with an upper respiratory tract infection (URI) has been a source of debate among pediatric anesthesiologists, nurse anesthetists, and perianesthesia nurses for many years. Although some studies suggest that anesthesia for the child with a URI increases the risk of perioperative respiratory complications, others suggest that these complications are easily managed and are not associated with any adverse sequelae. This article describes the pathogenesis of viral respiratory tract infections, reviews the literature regarding anesthesia and URIs, and discusses the assessment and management of the child who presents for elective surgery while harboring a URI. It is hoped that this information will be important to perianesthesia nurses and anesthesia providers in making decisions regarding proceeding or cancelling surgery for children with URIs and in optimizing their perioperative management.

Child↗
PubMed1997

[Clinical and experimental study on fuganlin oral liquid in treating repeated respiratory tract infection].

OBJECTIVE: To assess the efficacy of Fuganlin (FGL) oral liquid, a pure Chinese medicinal recipe in treating the repeated infantile respiratory tract infection. METHODS: FGL was used for repeated infantile respiratory tract infections. The children who took the antipyretic oral liquid as the control. Before and after treatment, immune function and other test were determined in both groups. Wistar rats taking FGL for three months was also observed. RESULTS: The curative and marked effective rates of the treated group were 76.8%, and the curative and marked effective rates of the control group were 48.0%. There are significant differences between the two groups (P < 0.01). CONCLUSIONS: FGL could not only modulate immune function but also could serve as a tonic as well as symptomatic relief for fever, cough, asthma, anti-viral, anti-bacterial infection and anti-inflammatory function.

Analgesics, Non-Narcotic↗
PubMed2006

Five-year cohort study of hospitalization for respiratory syncytial virus associated lower respiratory tract infection in African children.

OBJECTIVES: To describe the epidemiology of respiratory syncytial virus (RSV) associated lower respiratory tract infection (RSV-LRTI) hospitalizations in South African children over a 5-year period, and determine the impact of gestational age (GA) on the incidence of RSV-LRTI hospitalization. STUDY DESIGN: A cohort of 39,836 children, 6.47% of whom were HIV infected, enrolled into a phase 3 trial were prospectively studied for respiratory viruses when hospitalized for LRTI. RESULTS: The incidence of hospitalization for RSV-LRTI was 19.4 per 1000 in HIV uninfected children and 2.5-fold (95% CI 2.04-3.03) greater in HIV infected children (45.0 per 1000). The incidence of RSV-LRTI was 4.9-fold greater (95% CI 3.9-6.8) in children born at <36 weeks of gestational age (GA) and repeat hospitalizations for RSV-LRTI was 3.7-fold (95% CI 1.4-9.4) more likely in these children (7.3%) than children born at > or =36 weeks of GA (1.9%). The burden of RSV-LRTI was greater in children born at <32 weeks of GA than those born at 32-35 weeks of GA between 6-12 months (P=0.008) and 12-24 months of age (P=0.001). The RSV epidemic occurred at the end of the rainy season and peaked when the monthly temperatures were at its lowest each year.

Cohort Studies↗
PubMed1987

Efficacy and tolerance of ceftazidime in the treatment of post-operative respiratory tract infections.

Ceftazidime proved particularly effective in the treatment of acute respiratory tract infections arising in the immediate post-operative period, affording complete clinical cures in 88.8% of cases and a substantial improvement in the pathological picture in the other 11.2% of cases treated. The authors also draw attention to the excellent tolerance of the antibiotic, as evaluated on the basis of liver and kidney function and blood chemistry parameters and the total absence of adverse reactions.

Adult↗
PubMed1992

Efficacy and tolerance of roxithromycin in comparison with erythromycin stearate in patients with lower respiratory tract infections.

The efficacy and tolerance of roxithromycin 150 mg b.i.d. were compared with those of erythromycin stearate 500 mg b.i.d. in patients with lower respiratory tract infections. Out of 86 patients recruited for the study, 79 were evaluable for tolerance and 76 for efficacy. These patients were evenly distributed among the 3 investigational clinics, with 26, 25 and 28 patients, respectively. The diagnosis of lower respiratory tract infections was based on clinical, laboratory, radiological and/or physical findings and, when available, bacteriological and serological findings. The duration of treatment was 10 days, with follow-up at post-treatment visits directly after treatment and 6 weeks thereafter. The clinical outcome was satisfactory with no significant difference between the drugs. More patients reporting adverse events were on erythromycin than on roxithromycin (51.3% vs 17.5%; p = 0.003). The results suggest that roxithromycin is as effective as erythromycin stearate in the treatment of lower respiratory tract infections and causes fewer adverse effects.

Adult↗
PubMed1985

A combination of cefuroxime and N-acetyl-cysteine for the treatment of lower respiratory tract infections in children.

One hundred and three children with lower respiratory tract infections were treated with a combination of cefuroxime and N-acetyl-cysteine. Positive clinical results were obtained in 100 patients, symptoms being completely relieved in 58 and distinct improvement produced in 42. Chest x-rays provided objective evidence of recovery or improvement in these 100 patients. Of the 72 pathogenic strains isolated before treatment in the trial population as a whole, none were still detectable at the end of treatment. No side effects or adverse reactions of any kind were observed.

Acetylcysteine↗
PubMed1992

Epidemiology and prevention of respiratory tract infections due to nonencapsulated Haemophilus influenzae.

Nonencapsulated Haemophilus influenzae cause mainly respiratory tract infections, including otitis, sinusitis, and pneumonia. These infections may become chronic or recurrent in patients with bronchitis or otitis. Patients are usually infected with one strain at a time. During recurrent otitis, H. influenzae isolates have an outer membrane protein composition different from that seen during earlier episodes. In chronic bronchitis, H. influenzae strains persist for up to 1 year. In addition, isolates with different outer membrane protein compositions have been obtained that are antigenic variants of previous isolates. The variations occur in outer membrane protein b,c (P2), d (P5), or both. The variable parts are immunodominant, and antibodies to these parts are bactericidal. Cross-reactive bactericidal antibodies to outer membrane proteins have been elicited in immunized animals. These data indicate that natural immunity to nonencapsulated H. influenzae is mainly strain-specific but also that biologically active cross-reactive antibodies can be elicited by immunization.

Antibodies, Bacterial↗