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At least 757 records · Page 42Linked to original sources
PubMed1995

Clarithromycin versus cefaclor in lower respiratory tract infections. The Canadian Bronchitis Study Group.

A randomized study was done to compare the efficacy of clarithromycin 250 mg or 500 mg b.i.d., vs. cefaclor 250 mg or 500 mg t.i.d. for 7-14 d in 197 evaluable patients with lower respiratory tract infection. Ninety-five patients received clarithromycin, 88 with acute bronchitis or exacerbation of chronic bronchitis, and 7 with pneumonia. One hundred and two patients received cefaclor, 86 with bronchitis and 16 with pneumonia. Ten patients (10.5%) in the clarithromycin group did not complete the trial, 5 (5.3%) because of adverse event, and 3 (3.2%) because of clinical failure. Similarly, 11 patients (10.8%) did not complete cefaclor, 2 (2%) because of adverse event, and 7 (6.9%) because of clinical failure. Clinical cure or improvement was observed in 90 (94.7%) of patients on clarithromycin vs. 92 (90.2%) on cefaclor, p = 0.66. Bacteriologic cure was seen in 26/36 patients (72.2%) on clarithromycin vs. 28/40 patients (70%) on cefaclor, p = 0.28. Clarithromycin is just as effective as cefaclor for lower respiratory tract infections and is well tolerated.

Bronchitis↗
PubMed1994

Evaluation of the efficacy of pidotimod in the exacerbations in patients affected with chronic bronchitis.

The efficacy and safety of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl)carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6), a new oral synthetic immunostimulating agent, were investigated in a multicentre study, performed in 10 university and hospital centres of pneumophthisiology and respiratory physiopathology, according to a double-blind vs. placebo experimental design. Primary objective of the investigation was to verify the efficacy of pidotimod against infectious exacerbations in patients affected with chronic bronchitis. 181 inpatients or outpatients (117 male, 64 female; mean age: 62.5 years), affected with chronic bronchitis, were enrolled in the study. Pidotimod 800 mg/die or placebo sachets were administered by oral route for 60 consecutive days, followed by a 60-day follow-up period. Clinical observations were performed at baseline (D 0), after 30 (D 30) and 60 (D 60) days of treatment, as well as at the end of the follow-up (D 120). Time and frequency of infectious relapses were considered as the target variable for the evaluation of the efficacy of the drug. Clinical picture, expectoration characteristics, spirometric parameters and laboratory tests were monitored to evaluate patients' conditions. The results indicate that pidotimod is significantly more effective than placebo against infectious relapses in patients suffering from chronic bronchitis. During the first month, 9% of patients treated with pidotimod were affected with an infectious relapse vs. 39.5% of patients treated with placebo (chi 2, p < 0.001). In the second month, infectious episodes were reported by 1.2% of patients treated with the drug vs. 46.1% of patients treated with placebo (chi 2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Albuterol delivered by metered-dose inhaler to treat acute bronchitis.

BACKGROUND: Previous research has suggested that cough associated with acute bronchitis is more likely to subside within 7 days when treated with albuterol than with an antibiotic. This study examines the effectiveness of aerosolized albuterol for the treatment of acute bronchitis in patients treated with erythromycin or placebo. METHODS: A double-blind, randomized placebo-controlled trial of albuterol delivered by metered-dose inhaler (MDI) was conducted in a primary care setting with healthy adult patients who presented with a productive cough of fewer than 30 days' duration. In addition to randomization for albuterol, patients were also randomized to receive erythromycin or placebo. Outcomes were assessed at follow-up after 7 days. RESULTS: Patients treated with albuterol MDI were less likely to be coughing after 7 days of treatment than were patients using a placebo inhaler (61% still coughing vs 91%, P = .02). When analysis was stratified by cigarette smoking status and the use of erythromycin, the differences observed between albuterol MDI patients and controls persisted. CONCLUSIONS: Albuterol appears to reduce the likelihood that patients with acute bronchitis will be coughing after 7 days following initiation of treatment. This effect appears to be independent of cigarette smoking or the concomitant use of antibiotics.

Acute Disease↗
PubMed1995

Chemotherapy for chronic bronchitis. Controversies.

Chronic bronchitis is a common inflammatory disease of the airways characterised by cough, sputum production and associated features such as dyspnoea and respiratory obstruction. It has a poor prognosis once fully developed and imposes a heavy financial burden on affected societies. Chronic bronchitis is subject to periodic exacerbations in which the role of bacterial infection and the rightful place of antibiotic therapy is only slowly emerging, largely due to the non-homogeneity of the populations under study. Haemophilus influenzae is implicated as the pathogen in more than half of all bacterial exacerbations, Streptococcus pneumoniae and Moraxella catarrhalis accounting for a further third. Viruses and mycoplasmas are also involved. Some 18-25% of patients receiving domiciliary therapy may fail to respond to initial treatment, calling into question the efficacy of antibiotics in acute exacerbations. In part this may relate to sub-optimal respiratory pharmacokinetics as most antibiotics are quite effective against sensitive respiratory pathogens in vitro. However, bacterial resistance rates against traditional agents are rising rapidly in Europe and new agents are needed to counter this threat. Paradoxically few such agents have been shown to improve on the results of amoxycillin and other standard drugs, probably because most trials include patients with exacerbations of only mild-to-moderate severity due to sensitive pathogens. Since recent large scale studies have demonstrated the efficacy of antibiotic therapy compared with placebo in defined exacerbations, use of these definitions has allowed more realistic assessment of new agents which, in terms of improved antibacterial potency and respiratory pharmacokinetics, should offer superior efficacy. Regression analysis of a large scale general practice survey in the UK has now shown the frequency of exacerbations and the presence of co-morbid conditions to correlate significantly with a poor therapeutic outcome and thus, by implication, with severity. Future trials of antibacterial chemotherapy for acute bacterial exacerbations of chronic bronchitis should incorporate such criteria so that real differences between existing and improved compounds can be assessed.

Anti-Bacterial Agents↗
PubMed1993

[Lipid peroxidation and antioxidant defence in patients with pneumoconiosis and dust-induced bronchitis].

Lipids peroxidation (LP) and antioxidant defence (AD) were compared in the patients facing pneumoconiosis and dust bronchitis. The studied group included 35 patients with suspected pneumoconiosis, 75 patients facing the 1 grade of pneumoconiosis, 43 coniotuberculosis patients and 43 patients with dust bronchitis. Active LP was demonstrated, values and intensities of its stages depended on the origin and severity of disease. AD was characteristically depressed, which necessitates the antioxidant treatment of patients with pneumoconiosis and dust bronchitis.

Adult↗
PubMed1994

[Characteristics of clinical aspects and diagnosis of chronic bronchitis in workers of a phosphorus plant].

The clinical and functional examination of 306 workers engaged into phosphorus production diagnosed the chronic bronchitis due to toxic chemicals in 14.7% of examinees. In spite of various severity the bronchitis was characterized by the satisfactory general condition and preserved ability to work in most patients. The chronic bronchitis due to toxic chemicals in workers engaged into phosphorus production presents mostly obstructive respiratory disorders and sclerosis predominant over inflammation. Diffuse subatrophic and atrophic endobronchitis was diagnosed at the early stages of the disease.

Adult↗
PubMed1994

Pathogenesis of chronic bronchitis.

Inflammation of the central airways is a prominent feature in subjects with chronic bronchitis. The pathology of chronic bronchitis includes an inflammatory mononuclear cell infiltrate in the airway wall and a neutrophil influx into the airway lumen. The molecular events that produce the inflammation and its pathogenetic role in causing mucus hypersecretion are beginning to be elucidated. The inflammatory cell recruitment to the airways likely involves chemotactic agents derived not only from tissue fluid and invading microbes but also generated by the diseased bronchial epithelium. For example, bronchial epithelial cells synthesize interleukin (IL-8), a potent chemoattractant and activator of neutrophils and lymphocytes. Adhesion of infiltrating leukocytes to resident parenchymal cells in the bronchi and to extracellular matrix also is crucial for the development of airway inflammation. The resultant inflammation likely plays a direct role in the clinical features of the disorder. There is growing evidence incriminating neutrophil and lymphocytes constituents in the initiation and maintenance of cough and mucus expectoration that occurs in subjects with chronic bronchitis.

Bronchitis↗
PubMed1994

[Acute bronchitis in adults. Clinical findings, microorganisms and use of antibiotics].

Among 72 adult patients with a diagnosis of acute bronchitis, serological investigation established the presence of an aetiologic agent in 29 (40%). Influenza virus was the most common pathogen. Seven patients had bacterial infection, caused by pneumococci in four patients and Mycoplasma pneumoniae in three. Five of the patients had pneumonia as diagnosed by radiography, and mycoplasmal aetiology was established in one of these. Altogether, 11 patients either had bacterial infection or radiographic pneumonia. Although the doctors' recording of wheezes was strongly associated with prescription of antibiotics (p < 0.0001), wheezes were heard only in two of the 11 patients with pneumonia or bacterial infection, compared with 30 of the 61 patients with viral or unspecified bronchitis. The median value of C-reactive protein (CRP) was 52 mg/l in the 11 patients, significantly higher than < 11 mg/l in the 61 other patients (p < 0.0001). The corresponding values for erythrocyte sedimentation rate were 45 and 14 mm/h (p < 0.0005). The results indicate that certain patients with acute bronchitis should be treated with antibiotics, and that the erythrocyte sedimentation rate and the CRP-test may be useful in detecting which patients this applies to.

Acute Disease↗
PubMed1993

[A new conception of the pathogenesis of chronic bronchitis].

Clinical microbiological and immunological comparisons and data on various pneumococcal pathogenetic factors suggest chronic pneumococcal infections affecting cells and tissues of the bronchial tree to underlie pathogenesis of chronic bronchitis (CB). CB pathogenetic and clinical variants depend on the mechanisms regulating pneumococcal exudative and destructive inflammation. An obvious role of acute respiratory infections and acute bronchitis in the onset and aggravation of chronic bronchitis necessitates appropriate preventive measures.

Acute Disease↗
PubMedDate not supplied

[The etiological role of enterococci in chronic obstructive bronchitis].

The role of enterococci in the development of chronic obstructive bronchitis was determined. Enterococcus faecalis, subspecies zymogens and liquefaciens, were found to be the etiological factors of chronic obstructive bronchitis both as the primary cause of the disease and, probably, the cause of secondary hospital infection. Enterococci isolated from patients had some signs of pathogenicity, their characteristic feature being multiple drug resistance. Chronic obstructive bronchitis caused by these microorganisms was accompanied by decreased immune responsiveness and the development of autoimmune processes.

Antibody Formation↗
PubMed1975

[Investigations on mycoplasma attacks in patients with chronic bronchitis (author's transl)].

In 50 patients with chronic bronchitis, and additional attack by mycoplasma was found in at least 4 cases. This percentage corresponds approximately to the statements in the literature. In patients with mycoplasma in the sputum, radiologically signs of a bronchitis and peribronchitis were found which, for the short duration of the symptoms are unusual for a chronic bronchitis. Purulent sputum was only observed after several days in the many relapses which ran a course similar to a virus infection.

Adult↗
PubMedDate not supplied

[The air-blood barrier in chronic bronchitis deformans].

The authors studied the aerohematic barrier (AHB) in chronic bronchitis deformans in 30 children. Lung fragments obtained during the operation were examined. A morphofunctional study in chronic bronchitis deformans with and without bronchiectasia revealed uniform changes of the capillaries and epithelial elements. The AHB showed also some different changes. Namely, vacuolization of endothelial cells and an increase of type II alveocytes with small osmophilic lamellar bodies were more pronounced in chronic bronchitis deformans. Changes in AHB elements may be caused by immature lung parenchyma and by compensatory processes directed for restoration of structures destroyed by the inflammatory process.

Blood-Air Barrier↗
PubMed1993

[The neutrophil antibacterial function of patients with chronic bronchitis. Its immune correction by using inflammatory cytokines and allogeneic lymphocytes in vitro].

In patients with acute and chronic bronchitis decreased neutrophil phagocytic, induced O2-dependent metabolic, bactericidal activity and the content of lysosomal cationic proteins, increased spontaneous O2-dependent metabolic activity were revealed. The most pronounced neutrophil functional disorders were detected in patients with chronic obstructive bronchitis (COB). The use of human immunoregulatory recombinant cytokines (interleukin-1 beta, interferon-gamma, tumor necrosis factor alpha) failed to augment in vitro suppressed neutrophil antibacterial (phagocytic) activity in patients with COB. These patient's neutrophil antibacterial activity restored in vitro in the presence of allogeneic (nonactivated or interleukin-2-activated) lymphocytes. The data obtained provide evidence for healthy donor's lymphocytes use in immunocorrection of patients with chronic bronchitis.

Acute Disease↗
PubMed1993

Effects of seaprose on the rheology of bronchial mucus in patients with chronic bronchitis. A double-blind study vs placebo.

There are changes in the rheological characteristics of mucus (viscoelasticity) in several pulmonary pathologies, and especially in chronic bronchitis. Seaprose, a proteolytic enzyme, is one of the pharmacological possibilities for affecting the rheology of bronchial mucus to correct mucostasis and improve its clearance. The action of this drug on the viscoelasticity of bronchial mucus was assessed in a double-blind vs placebo study with 20 randomly balanced chronic bronchitis patients using a new kind of portable rheometer with special features designed for routine bronchial mucus analysis in clinical practice at the patient's bedside. It was found that in the group of patients who were given the placebo, there were no particular changes in the rheological behaviour of mucus, while in those patients who were given seaprose there were significant changes in both viscosity and elasticity at the end of treatment. Eight days after the end of treatment with seaprose, there was still a significant beneficial effect on the viscoelasticity of mucus and a sort of "post-mucolytic effect" can be postulated. Seaprose also had antiinflammatory action, and since in chronic bronchitis there are variable degrees of inflammations, its beneficial long-lasting effect could also be ascribed to this concomitant action.

Adult↗
PubMed1993

Twice daily dosing of erythromycin acistrate in the treatment of acute bronchitis and pneumonia.

Erythromycin acistrate (Erasis, CAS 96128-89-1) is a 2'-acetyl ester prodrug of erythromycin. Due to prolonged half-life it is more suitable for twice daily dosing than the conventional erythromycin preparations. In the present double-blind trial, totally 297 ambulatory patients with respiratory tract infections were treated either with erythromycin acistrate 800 mg daily or doxycycline 100 mg daily. 243 of the included patients had bronchitis, 15 patients bronchitis and other respiratory tract symptoms, 25 patients pneumonia and 14 other respiratory tract infections. The duration of treatment varied from 7 to 14 days depending on the severity of infection. The efficacy of both treatments was very good. 96.6% of the patients treated with erythromycin acistrate and 97.2% of the patients treated with doxycycline improved. The efficacy of erythromycin acistrate in the treatment of bronchitis and pneumonia was 96.7 and 100%, respectively. Only 5 of the totally 148 patients failed. Side effects (mainly gastrointestinal symptoms) were seen in 12.1% of the patients (20 patients in the erythromycin acistrate group and 16 patients in the doxycycline group). The results show that erythromycin acistrate dosed twice daily is as effective as doxycycline and well tolerated in the treatment of lower respiratory tract infections.

Acute Disease↗
PubMed1995

Haemophilus influenzae release histamine and enhance histamine release from human bronchoalveolar cells. Examination of patients with chronic bronchitis and controls.

Haemophilus influenzae (H. influenzae), Streptococcus pneumoniae (S. pneumoniae) and Branhamella catarrhalis (B. catarrhalis) are often found in the lower respiratory tract of patients with chronic bronchitis. Earlier studies have shown that bacteria induce mediator release from human basophils and parenchymal lung mast cells. In this study the capability of bacteria to trigger or potentiate histamine release from superficially located mast cells in the airway epithelium was studied in cell suspensions obtained by bronchoalveolar lavage in patients with chronic bronchitis (CB). In approximately half of the patients H. influenzae and Staphylococcus aureus (S. aureus) were found to trigger histamine release, whereas no response was obtained by S. pneumoniae or B. catarrhalis. The mediator release was caused by a non-IgE-dependent mechanism. At lower concentrations of H. influenzae causing no histamine release the bacterium was found to enhance IgE-mediated histamine release triggered by anti-IgE antibody. The synergy was more pronounced in patients with CB than in controls. Since H. influenzae is found in the lower respiratory tract of the patients but not in normal individuals, the infection here may via histamine release lead to harmful effects on the airways of importance for precipitation and exacerbation of chronic bronchitis.

Adult↗
PubMed1995

Prostanoids and cough response to capsaicin in asthma and chronic bronchitis.

Cyclooxygenase products are released by chronic airway inflammation. Our working hypothesis for the present study was that prostanoids augment airway cough sensitivity. The effects of a cyclooxygenase inhibitor, indomethacin (100 mg.day-1 for 4 days), and a thromboxane synthesis inhibitor, OKY-046 (400 mg.day-1 for 4 days), on cough response to inhaled capsaicin were examined in eight patients with asthma, 10 patients with chronic bronchitis, and 10 normal subjects. Capsaicin cough threshold, the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough sensitivity. In asthmatics, the cough thresholds with indomethacin treatment (15.7 (GSEM 1.38) microM) and OKY-046 (10.2 (GSEM 1.20) microM) were significantly greater than the value with placebo (6.05 (GSEM 1.25) microM). In patients with chronic bronchitis, the cough threshold was significantly greater with indomethacin (5.94 (GSEM 1.50) microM) than with placebo (3.41 (GSEM 1.33) microM and OKY-046 2.97 (GSEM 1.43) microM). In normal subjects, the capsaicin cough threshold was not altered by indomethacin or OKY-046 treatment. These results support our hypothesis and suggest that thromboxane A2 may be one of the cyclooxygenase products augmenting airway cough sensitivity in asthma, but not in chronic bronchitis.

Adult↗
PubMed1995

[Chlamydia pneumoniae infection in patients with pneumonia, bronchitis and acute upper respiratory tract infection in Beijing].

A prospective study for C. pneumoniae infection was conducted in 134 patients with acute respiratory disease and 134 matched patients with other medical reasons from January to May 1994 in Beijing. The positive rate of micro-IF (MIF) IgG antibodies was 93% (125/134) and 89% (119/134) respectively (0.1 < P < 0.25) and the geometric mean titers (GMT) were not found to be significant (55.9 +/- 4.2 vs 41.7 +/- 2.8, 0.1 < P < 0.20). Ten patients, four (4/30) with pneumonia and six (6/81) with bronchitis were serologically diagnosed as having recent C. pneumoniae infection. Chronic bronchitis was statistically more frequent in patients with C. pneumoniae infection than those without (0.025 < P < 0.05). Patients with chronic bronchitis (GMT, 87.1 +/- 3.9; n = 36) tended to have higher IgG titers than those without (GMT, 47.6 +/- 4.1; n = 98, 0.02 < P < 0.05). Culture of retro-pharyngeal swab specimens for C. pneumoniae was negative in the all 134 studied patients.

Adolescent↗