Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “RESPIRATORY TRACT INFECTIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed1988

[Laboratory and clinical studies of norfloxacin in respiratory tract infections].

Norfloxacin (NFLX), a new quinolone antibacterial agent, was investigated for its antibacterial activity and clinical efficacy on respiratory tract infections. The results obtained are summarized as follows: 1. Antibacterial activities were evaluated against 127 strains of various bacteria isolated from clinical sources. MIC80's of this drug were: against Staphylococcus aureus and Streptococcus pyogenes 1.56 micrograms/ml; Haemophilus influenzae 0.05 microgram/ml or less; and Klebsiella sp. and Enterobacter sp. 0.10 microgram/ml. These antibacterial activities were superior to these of ampicillin and cephalexin, except against S. pyogenes. 2. Clinical responses to NFLX in a total of 32 cases with respiratory tract infections were excellent in 9 cases, good in 12, fair in 9, poor in 2, with an efficacy rate of 65.6%. Neither adverse reactions nor abnormalities of laboratory test results were observed.

Adult↗
PubMed1989

[Usefulness of ceftazidime in intractable respiratory tract infections].

Usefulness of ceftazidime (CAZ) was studied in 56 cases of intractable respiratory tract infections. CAZ was administered at a daily dose of 2-4 g in 2 divided doses by intravenous drip infusion for 3-15 days. 1. Analysis was carried out in 38 cases and the following result was obtained. Efficacy rate was: 68% (17/25) in pneumonia, 60% (3/5) in chronic bronchitis and 67% (4/6) in secondary infections in chronic respiratory disease cases, and the overall efficacy rate was 63.2% (24/38). 2. In bacteriological study, 68.2% (15/22) of eradication rate was obtained. Against Staphylococcus aureus, eradication was obtained in all strains (4 strains). Against Pseudomonas aeruginosa, eradication occurred in 4 strains out of 10, and decrease in number in 2 strains. 3. As for adverse effects, mild hepatic disorder was observed in 2 cases (3.6%) out of 56. 4. From the above result, CAZ is considered to be very useful when used as monotherapy for aged patients and in the treatment of severe and intractable infections accompanied by underlying diseases.

Aged↗
PubMed1994

[Clinical usefulness of the combined empirical therapy with flomoxef and fosfomycin for intractable respiratory tract infections. With a background of increasing MRSA incidence].

We conducted a multicenter trial to determine the clinical usefulness of the combined therapy with flomoxef (FMOX) and fosfomycin (FOM) (FF therapy) as an empirical therapy in the treatment of intractable respiratory tract infections, because FF therapy has clinically been proved to be very useful for the treatment of severe infections including MRSA infections. The overall efficacy rate of FF therapy was 69.2%. The efficacy rate for "pneumonia/lung abscess," which occupy the largest portions of respiratory tract infections, was 70.0%, showing a statistically significant difference from the efficacy rate for FMOX alone (56.7%) found in a previous study (P = 0.09 by chi-squared test). Although MRSA was eradicated in only 3 cases (37.5%) including superinfection cases, of 8 patients, from whom MRSA had been isolated as causative organisms, none of our patients were superinfected with MRSA. Thus it has been concluded that FF therapy is clinically very useful when used as an empirical therapy in the treatment of respiratory tract infections.

Aged↗
PubMed2004

Lower respiratory tract infections and community acquired pneumonia in adults.

BACKGROUND: Lower respiratory tract infections--acute bronchitis and community acquired pneumonia (CAP)--are important causes of morbidity in Australia. Acute bronchitis is often treated with antibiotics, although the cause is usually viral. Community acquired pneumonia may be fatal, particularly in the elderly, therefore appropriate assessment and management is essential. OBJECTIVE: This article describes the aetiology, clinical assessment, investigations and management of acute bronchitis and CAP in the community. DISCUSSION: Clinical assessment is important for acute bronchitis and CAP, with investigations such as C reactive protein, serology, and chest X-ray informing diagnosis and management of the latter. Causative organisms are usually not identified, but are presumed to be viral for acute bronchitis, and Streptococcus pneumoniae for CAP; although 'atypicals' are also important. Antibiotics should generally not be prescribed for acute bronchitis, however, there is some evidence they may provide limited benefits in patients who have chest signs, are very unwell, are older, have comorbidities, or smoke. In patients with CAP, treated outside of hospital, the combination of amoxycillin and doxycycline/roxithromycin is the treatment of choice.

Acute Disease↗
PubMed1995

Lower respiratory tract infections following cardiac arrest and cardiopulmonary resuscitation.

All episodes of lower respiratory tract infection that developed among 96 patients surviving for > 24 hours after cardiac arrest were prospectively studied over an 18-month period. Pneumonia developed in 23 (24.0%) of patients after a mean of 7 days (SD, +/- 6.2 days). The development of four superinfections raised the cumulative incidence to 28.1%. Purulent tracheobronchitis was diagnosed in three instances. The causative agent of pneumonia was identified in 18 episodes, three of which were polymicrobial. Gram-positive cocci represented 57.1% of isolates, and Staphylococcus aureus--the most frequently isolated microorganism in this population--accounted for two-thirds of all gram-positive cocci. Pseudomonas aeruginosa was isolated in six episodes, five of which were associated with previous antibiotic use. Nine (39.1%) of the 23 patients in the group with pneumonia died, but only one of these deaths was considered to be directly related to pneumonia. In conclusion, pneumonia is a common complication of patients surviving cardiac arrest, but, with adequate treatment, its influence on outcome is marginal. Gram-positive cocci are the predominant pathogens, although infection with P. aeruginosa should be considered among patients receiving antibiotics.

Bronchitis↗
PubMedDate not supplied

Respiratory tract infections in children with recurrent episodes as preschoolers.

The occurrence of respiratory tract infections (RTI) in 41 school-age children, who had recurrent RTIs treated with antibiotics as preschoolers, was followed prospectively for two years through diary reports by parents and medical consultations, and compared with that in 29 children of the same age and socio-economic background, who had few or no such infections as preschoolers. During the two-year follow-up, a greater number of episodes of RTI and a longer mean duration of such episodes were reported in the diaries concerning the children with recurrent bacterial RTIs as preschoolers compared with the controls (p less than 0.01). The annual incidence of bacterial RTI from birth onwards decreased with age among the children with recurrent episodes as preschoolers, unlike in the control group, where the incidence remained consistently low, the difference in incidence being significant up to the age of eight years (p less than 0.01). Acute otitis media was the predominant bacterial RTI in preschoolers, and acute tonsillitis in school-age children. There was a tendency toward a greater incidence of other types of disease and complications/sequelae of infections among the RTI-afflicted group than among the controls, both as preschoolers and as school children. Our findings suggest that certain children constitute a group with high morbidity, susceptible to RTIs and other illnesses over a rather long period of years.

Adolescent↗
PubMed1985

Respiratory tract infections. Goals for 1995.

Goals to be identified for 1995, a decade hence, in the prevention, diagnosis, and management of respiratory tract infections may conveniently be divided into diagnostic goals and goals in therapy and prophylaxis. Major diagnostic goals for bacterial, viral, and mycoplasmal infections of the respiratory tract focus on the development of systems to identify microbial components, such as specific antigens or segments of DNA, using monoclonal antibody techniques or DNA probes for hybridization. Sputum cultures, in the traditional sense, should ultimately become obsolete. Management goals include the development of algorithms to identify patients who should be hospitalized, in contrast to those who can safely be treated on an outpatient basis. New antibiotic drug development should include drugs active against methicillin-resistant staphylococci, broad-spectrum beta-lactam drugs that are orally active against gram-negative bacilli, and drugs that can be used parenterally on a once-daily basis in settings other than the acute care hospital. There are certainly needs to enhance the present spectrum of antiviral drugs and to develop therapeutically useful immunomodulators. There are promising prospects for vaccine development, including live attenuated influenza virus vaccine, parainfluenza virus vaccine, respiratory syncytial virus vaccine, and a Mycoplasma pneumoniae vaccine. With major research support, such vaccines could possibly be fully developed by 1995. Finally, of greatest importance is the need to achieve greater utilization of existing vaccines, that is, inactivated influenza vaccine and the current 23-valent pneumococcal vaccine. A legitimate goal for 1995 would be to achieve 70 percent or greater utilization of these vaccines within the recommended target populations.

Anti-Bacterial Agents↗
PubMedDate not supplied

Etiology of acute lower respiratory tract infection in children from Alabang, Metro Manila.

The etiology of acute lower respiratory tract infection (ALRI) was identified in 235 (43.8%) of 537 hospitalized children less than 5 years of age. Clinical evidence of measles was found in 258 (48.0%) patients, of whom 59 had a second viral infection. A viral agent was identified in an additional 121 patients, so that a total of 379 (70.6%) had viral infections. After measles, respiratory syncytial virus was the most common respiratory virus. Bacteremia was noted in 72 children (13.4%), occurring as frequently in children with measles (14.8%) as in those without (12.1%); Haemophilus influenzae and Salmonella typhi were predominant in the former, and H. influenzae, Staphylococcus aureus, and Streptococcus pneumoniae were prominent in the latter. The presence of bacterial antigen in urine was not helpful in identifying bacterial infection. Extrapulmonary and intrapleural complications, concomitant measles, complicated ALRI, female gender, and malnutrition were associated with increased mortality among children with ALRI. The importance of measles immunization, vitamin A supplementation for alleviation of defects associated with malnutrition, and timely antimicrobial therapy is emphasized.

Acute Disease↗
PubMed1983

Cefoperazone versus cefamandole in the treatment of acute bacterial lower respiratory tract infections.

In a randomized comparative study, 113 patients were treated with cefoperazone or cefamandole for acute bacterial lower respiratory tract infections. Most patients had Streptococcus pneumoniae or Haemophilus influenzae infections, although five patients in the cefoperazone group had infections caused by other Gram-negative bacilli (two with Pseudomonas aeruginosa). The clinical responses and adverse effects were not significantly different between the two treatment groups. Satisfactory clinical responses occurred in 36/39 (92%) of evaluable patients in the cefoperazone group and 33/34 (97%) of evaluable patients treated with cefamandole. Two failures in the cefoperazone group were secondary to superinfection (Acinetobacter and Ps. aeruginosa). Bacteriological and symptomatic failure occurred in one patient with Ps. aeruginosa lung abscess treated with cefoperazone and in one patient with a polymicrobial empyema treated with cefamandole. The results of this study indicate that cefoperazone is safe and effective in the therapy of acute bacterial lower respiratory tract infections.

Acute Disease↗
PubMed1988

[Clinical trials of flomoxef in patients with chronic respiratory tract infections].

Flomoxef (FMOX, 6315-S), a newly developed oxacephem drug, was administered to 6 patients with chronic respiratory tract infections. Bacteriological examination of these infections using quantitative sputum cultures revealed that 2 patients had Haemophilus influenzae, 2 had Branhamella catarrhalis and 2 had mixed pathogens (one was with H. influenzae + B. catarrhalis and the other with Streptococcus pneumoniae + B. catarrhalis). The administration of the drug was done by drip infusion, twice daily, with a daily dose of 1 to 2 g. As results, all the above mentioned pathogenic organisms were eradicated in 5 to 10 days after the initiation of the drug therapy. No undesirable symptoms were observed in these patients during the course of the chemotherapy. Serum drug concentrations after an intravenous administration of the drug reached their peak values averaging 134.32 +/- 40.32 micrograms/ml immediately after a single dose of 2 g of FMOX in 5 patients with chronic respiratory tract infections. Drug concentration in the sputum was at highest 1.86 micrograms/ml. Susceptibilities to FMOX of clinically isolated 49 strains of H. influenzae and 35 strains of B. catarrhalis from our clinic in the year of 1986 were compared to those to ampicillin and to latamoxef (LMOX). The study revealed that MICs of FMOX against H. influenzae were 0.10 to 1.56 micrograms/ml, hence H. influenzae strains seemed to be sensitive to FMOX regardless of beta-lactamase activities. LMOX had higher activities against H. influenzae than FMOX, however. Activities of FMOX against B. catarrhalis, on the other hand, were distributed from less than 0.05 to 0.39 microgram/ml which were also not as good as LMOX activities.

Aged↗
PubMed1995

Once-daily tobramycin therapy in lower respiratory tract infections.

In a multicenter Italian study of 104 adult patients with severe bacterial lower respiratory tract infections, the safety and efficacy of a regimen of high dose, once-daily tobramycin alone or in combination with antipseudomonas betalactams was assessed. The overall bacteriological response was an elimination of the original pathogen in 70% of the patients while the overall clinical response mirrored the bacteriological results with a successful clinical outcome in 78% of patients. Adverse experiences were, in general, few and mild without oto- or nephrotoxicity. The once-daily, high dose regimen of tobramycin proved to be a safe and efficacious therapy for severe lower respiratory tract infections in adult patients.

Adult↗
PubMed1994

Allergic rhinitis and upper respiratory tract infections.

The existence of a relationship between allergic rhinitis and upper respiratory tract infection (URI) has not yet been verified. In a prospective study, 64 patients with allergic rhinitis and 23 non-allergic individuals were followed for 11.4 months. All participants kept a diary in which they recorded symptoms of URI, nasal discharge, blocked nose, sneezing and sinusitis. The allergic individuals did not have more frequent or more long lasting URI or sinusitis more frequently than non-allergic subjects.

Adult↗
PubMed1999

[Clinical and bacteriological effects of cefetamet pivoxil against community-acquired respiratory tract infections. Part III].

We investigated clinical and bacteriological effects of cefetamet pivoxil (CEMT-PI) on community-acquired respiratory tract infection and obtained the following results: This method of investigation was almost the same to those adopted in 1994 and 1996. 1. 512 cases of respiratory tract infection were treated with CEMT-PI under the same protocol at a total of 53 institutions in Tokyo, Kanagawa, Saitama, Chiba and Yamanashi prefectures from January, 1, 1998 over March, 31, 1998. Outpatients accounted for 99.7% of all subjects. Diagnoses given to these patients included pharyngolaryngitis (51.4%), tonsillitis (37.7%), and acute bronchitis (10.1%). 2. For the bacteriological study, a manual detailing the method of collecting specimens, storage and transport was distributed to the above-mentioned institutions. The isolation and identification of suspected causative bacteria, determination of minimum inhibitory concentrations (MICs), and investigation of beta-lactamase production were conducted all together at Section of Studies, Tokyo Clinical Research Center. Suspected causative bacteria were detected in 144 (37.2%) out of 387 cases that were the analytical subjects of the clinical efficacy. The major bacteria identified were 32 strains of Streptococcus pyogenes and 19 strains of Haemophilus influenzae. The clinical efficacy (the ratio of improvement) of CEMT by suspected causative bacterium was 84.4% against CEMT-indicated organisms and 81.2% against CEMT-non-indicated organisms. 3. We investigated clinical efficacy rates (the ratio of "markedly improved" + "improved") by disease. The improvement rate was 78.4% in pharyngolaryngitis, 87.0% in tonsillitis, and 79.5% in acute bronchitis. The clinical efficacy rate was an average of 81.9% in all CEMT-PI indicated diseases.

Adult↗
PubMed1988

Risk of acute non-specific upper respiratory tract infections in healthy men taking dapsone-pyrimethamine for prophylaxis against malaria.

The relative risks of non-specific upper respiratory tract infections were studied in two well matched groups of military recruits to see whether dapsone-pyrimethamine (Maloprim) given as antimalarial prophylaxis was associated with immunosuppression. Mean risks of upper respiratory tract infection were 64% higher in the study group than in the controls, the largest monthly differences being recorded in the months of harder training. These findings were unlikely to have been due solely to harder training in the study group, as concurrently measured sprains (arguably more likely to have been affected) were increased by only 19%. A more likely explanation was some degree of immunosuppression, physical stress possibly having a synergistic effect. These findings suggest that travellers taking dapsone-pyrimethamine as antimalarial prophylaxis may be rendered more susceptible to commoner infections, especially when engaged in increased physical activity.

Acute Disease↗
PubMed2005

The Use of Macrolides in Treatment of Upper Respiratory Tract Infections.

Antimicrobial resistance is a growing problem among upper respiratory tract pathogens. Resistance to beta-lactam drugs among Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes is increasing. As safe and well-tolerated antibiotics, macrolides play a key role in the treatment of community-acquired upper respiratory tract infections (RTIs). Their broad spectrum of activity against gram-positive cocci, such as S. pneumoniae and S. pyogenes, atypical pathogens, H. influenzae (azithromycin and clarithromycin), and Moraxella catarrhalis, has led to the widespread use of macrolides for empiric treatment of upper RTIs and as alternatives for patients allergic to b-lactams. Macrolide resistance is increasing among pneumococci and recently among S. pyogenes, and is associated with increasing use of the newer macrolides, such as azithromycin. Ribosomal target modification mediated by erm(A) and erm(B) genes and active efflux due to mef(A) and mef(E) are the principal mechanisms of resistance in S. pneumoniae and S. pyogenes. Recently, ribosomal protein and RNA mutations have been found responsible for acquired resistance to macrolides in S. pneumoniae, S. pyogenes, and H. influenzae. Although macrolides are only weakly active against macrolide-resistant streptococci species producing an efflux pump (mef) and are inactive against pathogens with ribosomal target modification (erm), treatment failures are uncommon. Therefore, macrolide therapy, for now, remains a good alternative for treatment of upper RTIs; however, continuous monitoring of the local resistance patterns is essential.

Journal Article↗
PubMedDate not supplied

The influence of case mix, site selection, and methods biases on costs of hospitalization for acute exacerbations of chronic obstructive airways disease and lower respiratory tract infections.

OBJECTIVE: To compare costs of hospitalization for lower respiratory tract infection (LRTI) in patients who received antibiotics before admission to those who did not, and in patients with and without underlying chronic obstructive airways disease (COAD) or diabetes mellitus. METHODS: All hospitalizations in a population of 366,849 residents in Tayside Scotland from 1993 to 1994 were analyzed. Three groups of patients were identified by primary discharge diagnosis in 1993/94 and previous admissions from 1980 to 1992: 1) acute exacerbation of COAD; 2) LRTI plus a secondary diagnosis of COAD or previous admission with COAD; 3) LRTI but no secondary COAD or previous admission with COAD. Setting specific costs were applied (e.g., general medicine, intensive care, geriatrics). Dispensed antibiotic prescribing in the 28 days before admission was identified from all community pharmacies. Nonparametric statistical tests were used. RESULTS: Patients with COAD were more likely to have received antibiotics before admission: COAD (n = 893) 49%; COAD + LRTI (n = 316) 43%; LRTI only (n = 822) 33%. Patients who received antibiotics before admission had lower hospital costs than patients who did not. Mean total costs per admission: COAD pound1604 versus pound1625 (p = .5); COAD + LRTI pound2281 versus pound2297 (p = .5); LRTI only pound2365 versus pound3233; (p = .009). Increasing age and diabetes mellitus were associated with higher hospital costs in all three groups. CONCLUSION: Economic models of the value of preventing hospital admissions for COAD or LRTI will be subject to case mix bias unless they adjust for age, community antibiotic use, and comorbidity.

Journal Article↗
PubMed1992

Disk diffusion antimicrobial assays of agents used in respiratory tract infections in intubated patients admitted to the intensive care unit (ICU) of Kenyatta National Hospital from November to December 1990.

Sensitivity patterns of bacterial isolates from respiratory tract infections to benzylpenicillin, gentamicin and ceftazidime were studied. In a period covering 8 weeks from November to December 1990, tracheal aspirates from a total of 22 intubated patients aged 6-54 years were taken. The duration of stay of patients in the unit by the time of specimen collection ranged from 2-92 days. Respiratory tract infections by pathogenic organisms set in earliest on day 4. Elevated temperatures (equal to or greater than 38 degrees C) and/or purulence in sputum were used as diagnostic indicators of respiratory tract infections. A total of 12 pathogenic organisms were obtained: Proteus spp, Pseudomonas spp, Klebsiella spp, Acinetobacter spp, Escherichia coli and Staphylococcus aureus. None of the 12 pathogens isolated was sensitive to benzylpenicillin; 50% of organisms were sensitive to gentamicin and all were sensitive to ceftazidime.

Adolescent↗
PubMed1988

[Clinical evaluation of sultamicillin fine granules in lower respiratory tract infection].

Sultamicillin (SBTPC) fine granules were given to 15 patients with respiratory tract infections at a dose of 375 mg 3 times a day. The results were excellent in 4 patients, good in 8, fair in 1 and poor in 2 with an efficacy rate of 80% which is comparable to that of SBTPC tablet (Unasyn tablet). One patient complained of difficulty in swallowing the drug probably due to its fine granular nature. No side effects nor abnormal laboratory test values due to this drug were observed in any of the patients enrolled in this study. From the above results, SBTPC fine granules seem to be useful in the treatment of pediatric and elderly patients who sometimes have difficulties in taking tablets.

Administration, Oral↗