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 883 records · Page 49Linked to original sources
PubMed1982

A case of IgA nephropathy associated with marked hematuria after upper respiratory tract infections.

IgA nephropathy is characterized by recurrent hematuria which is occasionally associated with upper respiratory infections. Since serial follow-up of IgA nephropathy has not been reported, a 43 year old patient who showed a typical course of this disease is described. Hematuria was markedly increased each time after upper respiratory infections. Renal biopsy revealed typical features of IgA nephropathy by light and immunofluorescent microscopy. Marked hematuria subsided after administration of antibiotics. Upper respiratory tract infections might be a risk factor in some patients with IgA nephropathy. In some patients upper respiratory tract infections may exacerbate IgA nephropathy.

Adult↗
PubMedDate not supplied

Short-course treatment of sinusitis and other upper respiratory tract infections with azithromycin: a comparison with erythromycin and amoxycillin. European Azithromycin Study Group.

In two randomized, multicentre studies patients with upper respiratory tract infections treated with 1.5 g azithromycin in five or six doses over 5 days were compared with patients treated with 10 g erythromycin in 40 doses over 10 days or 15 g amoxycillin in 30 doses over 10 days. The majority of azithromycin- (65%) and erythromycin- (67%) treated patients in the azithromycin/erythromycin study and all patients in the azithromycin/amoxycillin study had sinusitis. Clinical cure was recorded in 83% of azithromycin- and 79% of erythromycin-treated patients, and in 81% and 87%, respectively, of azithromycin- and amoxycillin-treated patients. There was no significant difference in bacteriological eradication between the treatments. Adverse events, predominantly mild or moderate gastro-intestinal complaints, occurred in 17% and 15%, respectively, of azithromycin- and erythromycin-treated patients, and in 5% and 11%, respectively, of azithromycin- and amoxycillin-treated patients but there were no serious laboratory safety abnormalities. Azithromycin appeared to be an effective, simplified treatment for upper respiratory tract infections and may improve patient compliance compared with standard therapies.

Adolescent↗
PubMed2006

Modelling hospital admissions for lower respiratory tract infections in the elderly in England.

Despite the importance of lower respiratory-tract infection (LRI) in causing hospitalizations in elderly patients (>or=65 years of age) and recent advances in vaccine development, a complete picture of the causative organisms is not available. All hospital discharge diagnoses (ICD-10 code) for LRI in elderly patients in England during 1995-1998 were reviewed. Using known seasonality in potential causative agents of LRI, the contribution of different respiratory pathogens to hospitalizations coded as 'unspecified LRI' was estimated by multiple linear regression analysis. Ninety-seven per cent of 551633 LRI-associated diagnoses had no specific organism recorded. From the statistical model the estimated proportions of admissions attributable to different pathogens were applied to calculate estimated hospitalization rates: 93.9 hospitalizations/10000 population aged >or=65 years due to S. pneumoniae, 22.9 to influenza virus, 22.3 to H. influenzae, 17.0 to whooping cough, and 12.8 to respiratory syncytial virus. There is enormous potential to improve health using existing vaccines and those under development.

Aged↗
PubMed2005

[Acute respiratory tract infections and acute coronary syndromes].

Epidemiological research indicates a correlation between respiratory-tract infections and acute cardiovascular events. Chronic infections have been linked to the development of atherosclerosis. As a result of chronic infections a prolonged and elevated inflammatory activity arises. Inflammation and the associated vessel-wall damage play an important role in the pathophysiology of atherosclerosis. Acute infections have been linked to a transient increased risk of unstable angina pectoris and an acute myocardial infarct. The consequence of acute infections is a systemic inflammatory response which results in changes in the atherosclerotic plaque, thrombotic activation and a prothrombotic condition. The inflammatory response and prothrombotic condition reinforce each other. This can result in coagulation on ruptured atherosclerotic plaques and erosions in the vessel wall, which can give rise to the sudden constriction or blockage of coronary arteries.

Acute Disease↗
PubMed1991

Thrombosis-inducing activity in plasma of patients with acute respiratory tract infection disappears after treatment.

Thrombosis-inducing activity (TIA) was identified in plasma from 16 of 27 patients (59%) with acute respiratory tract infections. On the other hand, it was present in only 9 of 79 subjects (11%) with chronic lung diseases and 4 of 49 healthy volunteers (8%). In the patients with acute respiratory tract infections, there were significant elevations in plasma fibrinogen, C-reactive protein and erythrocyte sedimentation rate in the TIA-positive group compared with the negative group. Plasma TIA disappeared in all of the 8 patients who were retested for TIA 2-5 weeks after they became disease free. Pneumonia was induced in rabbits by transbronchial injection of viable Escherichia coli. TIA was not present in plasma from normal rabbits, but it appeared in plasma collected 3 days after injection. It then disappeared after 1-2 weeks of treatment with antibiotics. TIA may serve as a marker for inflammatory responses and be a factor responsible for elevated blood coagulation activity in patients with acute infectious diseases.

Acute Disease↗
PubMed2005

Antibiotic prescribing for upper respiratory tract infection: the importance of diagnostic uncertainty.

OBJECTIVES: Antibiotic misuse for viral upper respiratory tract infections (URI) in children is a significant problem. We determined the influence on antibiotic prescribing of clinical features that may increase concern about possible bacterial infection (age, appearance, fever) in children with URI. STUDY DESIGN: We created 16 scenarios of children with URI and distributed them by mail survey to 540 pediatricians and family practitioners in Ontario, Canada. The association of patient clinical features, parental pressure, and physician characteristics with antibiotic prescribing was determined through the use of logistic regression analysis. RESULTS: A total of 257 physicians responded (48%). Poor appearance (OR, 6.50; 95% CI, 5.06 to 3.84), fever above 38.5 degrees C (OR, 1.48; 95% CI, 1.21 to 1.82), and age older than 2 years (OR, 2.27; 95% CI, 1.85 to 2.78) were associated with prescribing, whereas parental pressure was not. Physician characteristics associated with antibiotic use were family practitioner (OR, 1.54; 95% CI, 1.22 to 1.96), increasing number of patients seen per week (OR, 1.05; 95% CI, 1.01 to 1.08 for every 20-patient increase), and increasing physician age (OR, 1.17; 95% CI, 1.11 to 1.24, 5-year increments). CONCLUSIONS: Clinical factors, which may lead physicians to be concerned about possible bacterial infection in children, are associated with antibiotic use for pediatric URI.

Anti-Bacterial Agents↗
PubMed1993

Clinical studies of oral quinolone once daily in the treatment of lower respiratory tract infections.

The efficacy and safety of oral ofloxacin, 400 mg once daily, for the treatment of patients with lower respiratory tract infections were studied. The most common species recovered from the sputum specimens of these patients were Haemophilus influenzae, followed by Streptococcus pneumoniae (S. pneumoniae), Staphylococcus aureus (S. aureus), Gram positive cocci unidentified, Pseudomonas aeruginosa (P. aeruginosa), Morexella catarrhalis, Streptococcus epidermidis, and another Haemophilus species in this order. All these bacteria were susceptible to ofloxacin except for one strain of methicillin resistant S. aureus. A satisfactory clinical outcome was achieved in 34 of 40 patients (85%). It is concluded that ofloxacin, 400 mg once daily, is useful for patients with respiratory tract infections.

Administration, Oral↗
PubMed1999

Reliability of parental history of antibiotic use for Filipino children admitted with acute lower respiratory tract infection.

Parental history on antibiotic use and the urine antibacterial assay (UABA) result were compared in a study on Filipino children with acute lower respiratory tract infection (ALRI). Among 108 patients in whom urine for the UABA could be collected prior to starting antibiotic treatment in the hospital, 59 (55%) guardians reported preceding antibiotic use, 54% of whom were positive in the UABA. In another 37 (34%), the UABA result was positive, indicating nonreported use of antibiotics. Among 190 patients in whom urine could be collected only after intravenous administration of antibiotic, the UABA demonstrated large inhibition zones after the first dose in most patients but a negative result was seen in 14 cases. The inhibition zone radius was significantly smaller for chloramphenicol than for beta-lactam antibiotics (8.3 mm versus 16.1 mm after one dose; 95% confidence intervals = 7.0-9.7 and 14.9-17.2, respectively). Parental history on antibiotic use gives an underestimate of preceding antibiotic use in children with ALRI in the Philippines. The result partly explains the low yield of blood culture in many studies on ALRI, and stresses the need to develop new diagnostic methods not based on culture for those organisms highly sensitive to antibiotics such as Streptococcus pneumoniae and Haemophilus influenzae.

Acute Disease↗
PubMed1981

Orbital myositis after upper respiratory tract infection.

Two cases of isolated unilateral extraocular muscle myositis after antecedent upper respiratory tract infections are reported. Pain, inflammation over the involved muscle, restricted motility, and an enlarged muscle on computerized axial tomography scan are the findings. This is differentiated from conjunctival inflammatory disease and neurologic disorders. The treatment is orally administered steroids.

Adult↗
PubMed2005

Inverse association between Chlamydia pneumoniae respiratory tract infection and initiation of asthma or allergic rhinitis in children.

To evaluate the role of Chlamydia pneumoniae respiratory tract infection on pediatric asthma, allergic rhinitis or atopic eczema initiation, children of three age groups (n=1211) were prospectively studied for a C. pneumoniae infection using throat swabs and polymerase chain reaction (PCR) with enzyme immunoassay (EIA) detection. Infected children (study group, SG) were examined monthly until the agent could not be detected, quantifying persistent infection. They were compared with randomly selected, non-infected children without asthma matched for age, gender and origin (control group, CG) regarding lung function and inflammatory parameters as well as initiation of allergic diseases judged by family doctor diagnosis after, in median, 22 months. At the first follow-up examination, SG children revealed a higher leukotriene B4 (median 36 pg/ml vs. 19, p=0.04) and 8-isoprostane (median 15 pg/ml vs. 12, p=0.04) in breath condensate characterizing neutrophil, agent-related inflammation and oxidative stress in the lower airways. Cysteinyl leukotrienes, important in acute allergic inflammation, were without difference. Local, anti C. pneumoniae secretory immunoglobulin A antibodies were higher in children after C. pneumoniae infection (optical density median 0.7 vs. 0.4, p=0.001) confirming PCR-EIA results. At the final examination, there was no difference in pathological lung function tests, parameters of exhaled breath condensate or eosinophilia of the nasal mucosa. Incidence of asthma (0/55 vs. 5/54, p=0.03) and allergic rhinitis [3/53 vs. 10/52, p=0.04, odds ratio and 95% confidence interval-OR 0.25 (0.06;0.98)] as well as prevalence of asthma [1/56 vs. 9/58, p=0.02, OR 0.1 (0.01;0.81)] and allergic rhinitis [6/56 vs. 16/58, p=0.03, OR 0.32 (0.11;0.88)] were lower in the SG children. There was no association in atopic eczema. Three children with persistent infection revealed a slightly higher incidence in allergic rhinitis without significance than those with single C. pneumoniae detection (1/3 vs. 2/50), however, not to the CG. In conclusion a C. pneumoniae upper respiratory tract infection may be regarded as a protective factor for childhood asthma or allergic rhinitis in a population of kindergarten and school-age children.

Adolescent↗
PubMed2006

The role of Chlamydia pneumoniae in acute respiratory tract infections in young children in The Gambia, West Africa.

BACKGROUND: Little is known about the role of Chlamydia pneumoniae in the aetiology of acute respiratory tract infections (ARI) in children in developing countries. AIMS: To obtain better information, we studied the presence of C. pneumoniae and its association with clinical signs and symptoms of ARI in children under 5 years of age in The Gambia. METHODS: C. pneumoniae was sought by polymerase chain reaction in nasopharyngeal secretions and/or lung puncture aspirates from 324 infants under 3 months of age and 325 children between 3 months and 5 years of age with malnutrition, with or without pneumonia, and in control children. Clinical signs and symptoms for ARI and the spectrum of other viral and bacterial organisms were compared between those positive for C. pneumoniae and those negative. RESULTS: Of 324 young infants, ten (3.1%) showed the presence of C. pneumoniae whereas in the older children 50 of 325 (15%) were positive for C. pneumoniae. There was no significant association between clinical signs and symptoms of ARI and C. pneumoniae positivity in the young infants. Among older infants and children, there was a trend to more frequent lobar alveolar changes in those positive for C. pneumoniae. No bacterial pathogens were found to be significantly associated with C. pneumoniae infection. However, there was an association with measles in the malnutrition group and with RSV in the young infants group. CONCLUSIONS: In this study, C. pneumoniae was not associated with any particular clinical syndrome. We found no evidence that the organism plays a major role in ARI in young children in developing countries such as The Gambia.

Acute Disease↗
PubMed1998

Outcome for children under 5 years hospitalized with severe acute lower respiratory tract infections in Yemen: a 5 year experience.

Between 1991 and 1995, 2554 children under 5 years old hospitalized with severe acute lower respiratory tract infection in Al-Sabe'en, Sana'a, Yemen were studied. 47.7 per cent (1218) were under 6 months of age and 74.1 per cent (1893) were in their first 12 months. Sixty-four per cent (1633) were males. Of the 2554 cases, 221 died (overall, a case fatality rate of 8.7 per cent). 118 of the deaths (53.4 per cent) were in the under 6 months age group and 188 (85 per cent) were in the first 12 months age group. During 1995 the hospital started adopting the WHO standard case-management guidelines for treating severe acute lower respiratory tract infections. There were no significant reductions in case fatality rates in 1995 (CFR 9.8 per cent) compared with those of 1991 (CFR 7.9 per cent), 1992 (CFR 9.4 per cent), 1993 (CFR 7 per cent), or 1994 (CFR 8.5 per cent). Factors such as late hospital admission with cyanosis, malnutrition, rickets as well as increased resistance of the common causative organisms (pneumococci and H. influenzae) to antibiotics recommended by the WHO may have contributed to such a high case fatality rate remaining unchanged. In addition to reducing the risk of developing pneumonia and dying from pneumonia by improving maternal nutrition, health education, promoting breastfeeding, and preventing rickets and nutritional anaemia among the vulnerable age groups, vaccination against pneumococci and H. influenzae type b should be seriously considered as one of the strategies to reduce lower respiratory tract infection-related mortality.

Acute Disease↗
PubMed1990

[Therapeutic efficacy of ceftibuten in chronic respiratory tract infections].

We evaluated the therapeutic efficacy of ceftibuten (CETB, 7432-S), a new cephem antibiotic for oral use, in chronic respiratory tract infections. A daily dose of 400 mg (b.i.d.: 15 cases) or 600 mg (t.i.d.: 5 cases) of CETB was given orally for 3-14 days (mean: 10.6 days) to 20 patients: 9 with infected bronchiectasis, 3 with infection supervened on pulmonary emphysema, 3 with acute pneumonia (supervened on bronchiectasis in 2 of 3 cases), 2 with infected bronchial asthma, 1 each with infection supervened on old pulmonary tuberculosis, chronic bronchitis and pulmonary fibrosis. The clinical effects were excellent in 3, good in 11, fair in 3 and poor in 3. Eighteen strains were identified as causative organisms. Eight of 15 strains for which bacteriological responses were evaluable were eradicated by the use of CETB. Eosinophilia in 2 patients and an elevation of S-GPT value was observed in 1 patient. These adverse reactions disappeared after the completion of the therapy. From the above results, we conclude that CETB is one of the most useful antibiotics for oral use as a first choice in chronic respiratory tract infections.

Adult↗
PubMed1996

Diagnosis of viral respiratory tract infections in children by using a reverse transcription-PCR panel.

Reverse transcription-PCR (RT-PCR) is a sensitive method for detection of RNA virus nucleic acid sequences in clinical respiratory specimens. Previous studies have focused on RT-PCR for a single virus, but this approach is limited by the inability to establish a specific etiology when the RT-PCR result is negative and by the inability to document simultaneous infections involving more than one virus. The purpose of this study was to apply a panel of RT-PCR protocols for respiratory syncytial virus, parainfluenza virus, and picornaviruses to respiratory specimens from 80 children suspected to have acute viral respiratory tract infections and to correlate RT-PCR results with viral culture results and clinical diagnosis. In comparison with viral culture, the RT-PCR panel had a sensitivity of over 94% and showed evidence of simultaneous infections in a significantly greater proportion of specimens (20.0% versus 3.8%; P < 0.002). For specimens in which no viruses were detected by culture, the proportion of specimens with positive picornavirus RT-PCR results was significantly greater than the proportion of specimens with positive respiratory syncytial virus or parainfluenza virus RT-PCR results (P < 0.001). There were no statistically significant associations between RT-PCR results and clinical diagnosis. In summary, the RT-PCR panel provides an improved approach to obtain new insights into acute viral respiratory tract infections in children.

Base Sequence↗
PubMed2002

Outcomes in lower respiratory tract infections and the impact of antimicrobial drug resistance.

Numerous published studies have documented the rapid rise in antimicrobial drug resistance among common respiratory pathogens, particularly Streptococcus pneumoniae. Yet, surprisingly few studies have evaluated the impact of these in vitro findings on clinical outcomes. Outcomes research is the measurement of the impact of illness and the effect of treatment on clinically relevant end-points. Studies of patients with community-acquired pneumonia have established certain expected rates of outcomes, including mortality, clinical complications, and time to resolution of symptoms. Recent studies have identified specific processes of care and treatment choices that have an impact upon these outcomes. However, there are no well-controlled studies that provide definitive estimates of the magnitude of the impact of antimicrobial therapy on these outcomes for patients with community-acquired pneumonia or other respiratory tract infections, such as acute exacerbations of chronic bronchitis. Most studies of the impact of drug resistance on outcomes for patients with respiratory tract infections have focused on the impact of beta-lactam drug resistance on outcomes for patients with community-acquired pneumococcal pneumonia. In general, these studies have demonstrated that outcomes are not affected by current levels of drug resistance, but most studies are hampered by small sample size, inability to control adequately for severity of illness and concordance of therapy, and inclusion of few subjects with high-level drug resistance. Additional studies are urgently needed to assess better whether the current empiric treatment guidelines are adequate or will need to be adjusted as patterns of resistance continue to evolve.

Bronchitis, Chronic↗
PubMed2001

Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods.

The need to decrease excess antibiotic use in ambulatory practice has been fueled by the epidemic increase in antibiotic-resistant Streptococcus pneumoniae. The majority of antibiotics prescribed to adults in ambulatory practice in the United States are for acute sinusitis, acute pharyngitis, acute bronchitis, and nonspecific upper respiratory tract infections (including the common cold). For each of these conditions--especially colds, nonspecific upper respiratory tract infections, and acute bronchitis (for which routine antibiotic treatment is not recommended)--a large proportion of the antibiotics prescribed are unlikely to provide clinical benefit to patients. Because decreasing community use of antibiotics is an important strategy for combating the increase in community-acquired antibiotic-resistant infections, the Centers for Disease Control and Prevention convened a panel of physicians representing the disciplines of internal medicine, family medicine, emergency medicine, and infectious diseases to develop a series of "Principles of Appropriate Antibiotic Use for Treatment of Acute Respiratory Tract Infections in Adults." These principles provide evidence-based recommendations for evaluation and treatment of adults with acute respiratory illnesses.This paper describes the background and specific aims of and methods used to develop these principles. The goal of the principles is to provide clinicians with practical strategies for limiting antibiotic use to the patients who are most likely to benefit from it. These principles should be used in conjunction with effective patient educational campaigns and enhancements to the health care delivery system that facilitate nonantibiotic treatment of the conditions in question.

Acute Disease↗
PubMed1997

Accelerated bacteriological evaluation in the management of lower respiratory tract infection in general practice.

This paper examines the use of overnight accelerated bacteriological evaluation (ABLE) in the treatment of lower respiratory tract infection in general practice. The use of ABLE is compared with the empirical prescribing of antibiotics. The results indicate that ABLE leads to a saving in resource use without a deterioration in clinical outcome. In view of there being additional benefits, such as reduced antibiotic exposure and repeat visits, it is concluded that the use of ABLE in the way described would improve the management of lower respiratory tract infection in general practice.

Anti-Bacterial Agents↗