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 973 records · Page 54Linked to original sources
PubMed1999

[Epidemiology of resistance to antibiotics in respiratory tract infections].

AN EVOLVING PROBLEM: Antibiotic resistance currently concerns H. influenzae, S. pneumoniae, S. pyogenes, M. catarrhalis, all species which are particularly susceptible to beta-lactamines, fluoroquinolones and macrolides. Incidence of resistance has reached high levels in many countries, including France in certain instances. BETA-LACTAMINE RESISTANCE: Penicillin-resistant pneumococci (partial and total resistance) are unequally distributed over the globe. In France the frequency is high, particularly in children. S. pyogenes strains remain sensitive to peni-G. Amino-penicillin resistance of H. influenzae and M. catarrhalis results from enzymatic processes (penicillinase production) and concerns an important proportion of the strains, particularly for M. catarrhalis. FLUOROQUINOLONE-RESISTANCE: Fluoroquinolone resistance is now described for H. influenzae. Though rare, this is a serious problem as it proves that this bacterial species can adapt to new antibiotics used for the treatment of respiratory tract infections. Resistance is acquired by modifying the antibiotic target, DNA gyrase and/or topo-isomerases, enzyme implicated in bacterial DNA. The presence of multiple mutations in the genes coding for these enzymes raises the MIC for fluoroquinolones, including those for the most recent compounds. Streptococci resistance to fluoroquinolones is increasing but no new mechanisms of resistance have been described. MACROLIDE-RESISTANT STREPTOCOCCI: Acquired resistance results either from the presence of erm genes causing a modification in the bacterial ribosome by methylation or by the presence of mef genes coding for efflux proteins. Incidence of macrolide resistance and the distribution of these different mechanisms vary greatly from one country to another. EMPIRICAL TREATMENT OF RESPIRATORY TRACT INFECTIONS: Epidemiological data and the locoregional bacterial ecology must be considered when prescribing an empirical treatment for respiratory tract infections.

Anti-Bacterial Agents↗
PubMedDate not supplied

Use of a polyvalent bacterial lysate in patients with recurrent respiratory tract infections: results of a prospective, placebo-controlled, randomized, double-blind study.

Respiratory tract infections (RTIs) are the most common infections in humans, and it is difficult to effectively treat patients with increased susceptibility to these ailments. LW 50020 (Luivac; Paspat oral), an oral immunomodulator consisting of the antigens of seven bacteria commonly involved in RTIs, has been developed for the induction of specific and nonspecific immune responses of the mucosa-associated lymphoid tissue. In this placebo-controlled study, the efficacy and safety of the tablet formulation of LW 50020 were evaluated in children and adults with recurrent RTIs. Tablets were taken once daily during two periods of 4 weeks each, interrupted by a treatment-free interval of 4 weeks. The main endpoint of the study, a clinical severity score that evaluated treatment benefits, was significantly lower in the second study period in patients treated with the bacterial lysate compared to patients given placebo. A comparison of the infection rates in the first and second study periods of patients treated with LW 50020 revealed a placebo-corrected reduction of 39% in children and a placebo-corrected reduction of 44% in adolescents and adults. The placebo-corrected duration of infections was shortened by 47% in children and by 55% in older patients. No serious drug-related side effects occurred. This study demonstrated that the oral bacterial immunomodulator LW 50020 is efficacious in treating patients with recurrent RTIs.

Adjuvants, Immunologic↗
PubMed1988

Blinded comparison of cefuroxime to cefaclor for lower respiratory tract infections.

Cefuroxime axetil was compared with cefaclor for the therapy for lower respiratory tract infections. Sixty-one patients were randomized to receive the following drug dosages: (1) cefuroxime axetil, 250 mg orally every 12 hours (21 patients); (2) cefuroxime axetil, 500 mg orally every 12 hours (21 patients); and (3) cefaclor, 500 mg orally every eight hours (19 patients). Of these 61 patients, 80% were male, with a mean age of 59.5 years; 56% had acute pneumonia, and the remainder had an acute bronchitis. Causative pathogens included typical respiratory tract pathogens. Overall, 23 of 27 patients with bronchitis were clinically cured at the end of therapy. Thirty-one of 34 pneumonias were clinically cured or improved at the end of therapy; the three pneumonia treatment failures occurred in the lower dose cefuroxime (n = 2) and cefaclor (n = 1) treatment groups. Overall, bacteriologic cure occurred in 86% of patients treated with 500 mg of cefuroxime axetil compared with 60% of cefaclor-treated patients. Adverse clinical effects were uncommon. From this study, it was concluded that cefuroxime given every 12 hours is at least as clinically efficacious as cefaclor; it is a new oral cephalosporin with pharmacologic and bacterial spectrum advantages over many older agents.

Acute Disease↗
PubMed2004

Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials.

OBJECTIVE: To assess the efficacy of Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection. METHODS: Systematic review of the literature and meta-analysis of randomized controlled trials. Mean difference in the reduction in symptom severity scores between treatment and control groups was calculated to obtain an overall estimate of effect. RESULTS: Four studies met our inclusion criteria and were reviewed. A total of 433 patients reported in three trials were included in the statistical analysis. Andrographis paniculata fixed combination with Acanthopanax senticosus was more effective than placebo. The mean difference was 2.13 points (95% CI 1.00-3.26 points, P=0.0002) on the symptom severity score. The difference in effects between A. paniculata and placebo was 10.85 points (95% CI 10.36-11.34 points, P<0.0001) in favour of A. paniculata. CONCLUSION: Current evidence suggests that A. paniculata extract alone or in combination with A. senticosus extract may be more effective than placebo and may be an appropriate alternative treatment of uncomplicated acute upper respiratory tract infection.

Acute Disease↗
PubMedDate not supplied

Patterns of acute respiratory tract infection in children: a longitudinal study in a depressed community in Metro Manila.

The incidences of acute respiratory tract infection (ARI) and acute lower respiratory infection (ALRI) were 6.1 and 0.5 per child-year, respectively, in children less than 5 years old in a depressed urban community in Manila. The peak age-specific incidence occurred in those children 6-23 months old for ARI and 6-11 months old for ALRI. Age less than 2 years, malnutrition, household crowding, and parental smoking were associated with a statistically significant, though modest, increase in ARI morbidity. The crude mortality rate was 14.3 per 1,000 children 0-4 years old, with a corresponding ARI-specific mortality rate of 8.9 per 1,000. The prevalence of viral infection was 32.8 and that of bacteremic ALRI was 6.7 per 1,000 children with moderate ALRI. Respiratory syncytial virus was the predominant viral pathogen, while Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus were the most frequently isolated bacterial pathogens. Transmission of respiratory pathogens in depressed communities, facilitated by inadequate housing, inaccessible health services, and prevalent malnutrition, will continue unless meaningful socioeconomic improvement is realized.

Acute Disease↗
PubMed1992

Respiratory tract infection complicating transtracheal oxygen therapy.

Transtracheal oxygen is generally well tolerated in patients with chronic hypoxemia. Minor complications are common, but there are few reports of serious respiratory tract infections associated with transtracheal oxygen therapy. We describe four patients with interstitial lung disease who had frequent lower respiratory tract infections requiring hospitalization after initiation of transtracheal oxygen therapy.

Aged↗
PubMed2004

New developments in antibacterial choice for lower respiratory tract infections in elderly patients.

Elderly patients are at increased risk of developing lower respiratory tract infections compared with younger patients. In this population, pneumonia is a serious illness with high rates of hospitalisation and mortality, especially in patients requiring admission to intensive care units (ICUs). A wide range of pathogens may be involved depending on different settings of acquisition and patient's health status. Streptococcus pneumoniae is the most common bacterial isolate in community-acquired pneumonia, followed by Haemophilus influenzae, Moraxella catarrhalis and atypical pathogens such as Chlamydia pneumoniae, Legionella pneumophila and Mycoplasma pneumoniae. However, elderly patients with comorbid illness, who have been recently hospitalised or are residing in a nursing home, may develop severe pneumonia caused by multidrug resistant staphylococci or pneumococci, and enteric Gram-negative bacilli, including Pseudomonas aeruginosa. Moreover, anaerobes may be involved in aspiration pneumonia. Timely and appropriate empiric treatment is required in order to enhance the likelihood of a good clinical outcome, prevent the spread of antibacterial resistance and reduce the economic impact of pneumonia. International guidelines recommend that elderly outpatients and inpatients (not in ICU) should be treated for the most common bacterial pathogens and the possibility of atypical pathogens. The algorithm for therapy is to use either a selected beta-lactam combined with a macrolide (azithromycin or clarithromycin), or to use monotherapy with a new anti-pneumococcal quinolone, such as levofloxacin, gatifloxacin or moxifloxacin. Oral (amoxicillin, amoxicillin/clavulanic acid, cefuroxime axetil) and intravenous (sulbactam/ampicillin, ceftriaxone, cefotaxime) beta-lactams are agents of choice in outpatients and inpatients, respectively. For patients with severe pneumonia or aspiration pneumonia, the specific algorithm is to use either a macrolide or a quinolone in combination with other agents; the nature and the number of which depends on the presence of risk factors for specific pathogens. Despite these recommendations, clinical resolution of pneumonia in the elderly is often delayed with respect to younger patients, suggesting that optimisation of antibacterial therapy is needed. Recently, some new classes of antibacterials, such as ketolides, oxazolidinones and streptogramins, have been developed for the treatment of multidrug resistant Gram-positive infections. However, the efficacy and safety of these agents in the elderly is yet to be clarified. Treatment guidelines should be modified on the basis of local bacteriology and resistance patterns, while dosage and/or administration route of each antibacterial should be optimised on the basis of new insights on pharmacokinetic/pharmacodynamic parameters and drug interactions. These strategies should be able to reduce the occurrence of risk factors for a poor clinical outcome, hospitalisation and death.

Aged↗
PubMed1990

[Clinical evaluation of cefteram pivoxil in respiratory tract infections].

The usefulness of cefteram pivoxil (CFTM-PI) was evaluated in 99 cases with respiratory tract infections: 32 cases with acute bronchitis, 51 cases with infectious exacerbations of chronic respiratory diseases and 16 cases with pneumonia. 1. The clinical efficacies included marked improvement in 27 cases, improvement in 51 cases, moderate improvement in 9 cases, no change in 10 cases and deterioration in 2 cases. The improvement rate was 78.8%. 2. Overall effects were excellent in 12 cases, good in 9 cases and fair in 5 cases. There was no case in which efficacy was not observed and the efficacy rate was 80.8%. 3. Bacteriological effects were classified according to the causative organisms. Eradication rate was 80.8% (21 of 26 strains), indicating an excellent antibacterial action of CFTM-PI. In particular, MICs of cefteram were below 0.05 microgram/ml against all 10 strains of Haemophilus influenzae regardless of beta-lactamase production even with an inoculum of 10(8) or 10(6) cells/ml. 4. Side effects rarely occurred and included a slight gastrointestinal irritation in 4 of 99 cases (4%). Two cases which had abnormal elevations of GOT and GPT had abnormal values prior to administration of CFTM-PI. The elevations were slight and it was possible to continue administration. The GOT and GPT values were improved after the end of administration. The above results indicate the usefulness of CFTM-PI in acute respiratory infections and infectious exacerbation of chronic respiratory diseases.

Adult↗
PubMed2004

Assessment of neutrophil components as markers of lung injury in the course of bovine respiratory tract infections.

To define the role of activated neutrophils in lung injury during bovine respiratory tract infections (BRTI) their in vitro function was investigated. As a means to achieve this goal the comparison of secretory action between neutrophils from the BRTI group and control was made on the basis of elastase, myeloperoxidase (MPO), alkaline phosphatase (ALK-P) release, and nitric oxide production. We noted that there is an interdependence between secretory response of neutrophils and clinical severity of BRTI. The release of elastase was greater in the BRTI group than in the control group (49.17+/-4.41 versus 46.43+/-4.95% of the total content). Neutrophils from infected heifers exhibited a significantly (p<0.05) higher value of MPO release than from healthy heifers and reached 39.23+/-10.18 versus 25.54+/-8.41% of the total content. ALK-P containing granules released significantly (p<0.001) more enzyme in the group with BRTI than in the control group (22.42+/-6.27 versus 13.74+/-2.01% of the total enzyme content). The level of nitrite accumulation rose in the culture of cells isolated from heifers with BRTI from 4+/-0.53 microM after 0.5h to 6.9+/-0.52 microM after 72 h. Our data suggest that during BRTI the increase of neutrophil secretory action results in augmentation of enzyme release including elastase, MPO and ALK-P, and the nitrite production. During an excessive secretory response of neutrophils all these factors contribute to lung injury and worsen the course of a disease and might be recognised as markers of lung injury. Moreover, such a destructive action of neutrophils must be taken into account during the introduction of new methods of BRTI treatment.

Alkaline Phosphatase↗
PubMed1987

Subacute zinc deficiency in children with recurrent upper respiratory tract infection.

Serum, urine and hair zinc levels in 20 patients with recurrent upper respiratory tract infection are compared with those of age- and sex-matched controls. Lower hair zinc (1.44 vs 2.00 mmol/g hair, P = 0.004) and higher urinary zinc levels (2.2 vs 1.6 mmol/mol creatinine, P = 0.05) were found, but no difference in serum zinc. The patients had lower-normal height for age (SD-score 0.2 vs 0.7, P = 0.031), there was no difference in weight for height. No correlation was found between the zinc values and the duration of the complaints.

Child↗
PubMed1993

A single-blind comparison of three-day azithromycin and ten-day co-amoxiclav treatment of acute lower respiratory tract infections.

The efficacy and safety of a three-day regimen of azithromycin (500 mg od) and a ten-day regimen of co-amoxiclav (625 mg tid) were compared in a single-blind study in 99 patients with acute lower respiratory tract infections. Of these, 70 (71%) suffered an infective exacerbation of their chronic obstructive pulmonary disease. Nine patients had pneumonia and 19 purulent bronchitis. Treatment success, defined as cure or improvement, occurred in 43 of 48 (90%) patients in the azithromycin group, compared with 45 of 51 (88%) patients in the co-amoxiclav group. The most common isolated pathogens were Haemophilus influenzae (25 cases; MIC range of azithromycin (A) < or = 0.06-4 mg/L; for co-amoxiclav (CA) 0.25-4 mg/L; Streptococcus pneumoniae (10 cases; A: < or = 0.06- > 128; CA: < or = 0.06); and Moraxella catarrhalis (four cases; A: < or = 0.06; CA: < or = 0.06-0.25). Microbiological response rates were comparable in the two groups. In 5% of patients, serological evidence for virus or atypical pathogens was found. Thirteen (26%) patients treated with co-amoxiclav had gastrointestinal complaints (seven with diarrhoea), compared with five (10%) treated with azithromycin (P = 0.09). Additional complaints occurred in three patients treated with co-amoxiclav and in one patient treated with azithromycin. It was concluded that a three-day regimen of azithromycin was as effective, clinically and microbiologically, as a ten-day regimen of co-amoxiclav in the treatment of acute lower respiratory tract infections.

Adult↗
PubMed2002

Bacterial flora in foals with upper respiratory tract infections in Poland.

Bacteria isolated from nasal cavity of 80 foals with upper respiratory tract infection, as well as from 20 healthy foals, were examined. Within the group of sick animals, from 18 (22.5%) bacteria with recognized pathogenicity were isolated. Coagulase-negative staphylococci and Acinetobacter sp. were the dominant species identified (100 and 45%, respectively). No bacteria species with recognized pathogenicity were isolated from the group of healthy animals. Three cases of death within the group of sick foals were investigated. Rhodococcus equi in two cases and Klebsiella pneumoniae pneumoniae together with Escherichia coli were isolated post-mortem from lung abscesses.

Acinetobacter↗
PubMed1994

[Clinical study on repeated infantile respiratory tract infection treated by kanggan zhibao oral liquor].

The clinical observation of repeated infantile respiratory tract infection treated by Kanggan Zhibao (KGZB) oral liquor and controlled with levomisole was studied. The results showed that the total effective rate of KGZB was 93.2%, which was significantly more effective than that of the control group (P < 0.05). In relieving symptoms and signs, KGZB was also superior to the control group (P < 0.05). Both the KGZB and the levomisole could enhance and modulate the immunity function of T-lymphocyte and they could increase RBC-C3b receptor rosette formation rate, so that it had no significant difference in comparing with the healthy group (P > 0.05). It suggested that the therapeutic mechanism was related to this.

Adolescent↗
PubMed1987

A comparison of the efficacy and safety of cefuroxime axetil and augmentin in the treatment of upper respiratory tract infections.

Cefuroxime axetil (CAE), an orally absorbed prodrug of cefuroxime, was evaluated for its efficacy and safety in the treatment of upper respiratory tract infections (tonsillitis, pharyngitis, sinusitis and otitis media) in general practice in the United Kingdom. A total of 385 patients aged 14 or over were enrolled in a randomized study to compare cefuroxime axetil 250 mg b.d. for 5 days with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. for 5 days. Of 175 clinically assessable patients treated with cefuroxime axetil, 136 were cured and 33 improved (97% success rate). Of 188 assessable patients given Augmentin, 155 were cured and 29 improved (98% success rate). Sixty-four patients treated with cefuroxime axetil were evaluable for bacteriological response: 47 (73%) of the causative pathogens were eradicated, as compared with 62 of 86 (72%) in patients treated with Augmentin. Thirteen out of 181 (7%) patients treated with cefuroxime axetil experienced drug-related adverse events, including 4% with diarrhoea. In the Augmentin group 24 out of 204 (12%) patients had a drug-related adverse event, including 5% with diarrhoea. In conclusion, cefuroxime axetil at a dose of 250 mg b.d. appears to be as safe and effective as Augmentin at the higher dose of 375 mg t.d.s. in the treatment of upper respiratory tract infections.

Adolescent↗
PubMed1998

[Antimicrobial activities of cefcapene against clinical isolates from respiratory tract infections of outpatients].

In order to evaluate antimicrobial activity of cefcapene (CFPN), minimum inhibitory concentrations (MICs) of CFPN and reference drugs were determined against clinical isolates from respiratory tract infection of out patients that were obtained in our laboratory from January to June of 1997. The results are summarized as follows; 1. The MIC90 of CFPN against penicillin (PC)-susceptible Streptococcus pneumoniae (PSSP) was equal to those of benzylpenicillin (PCG), ampicillin (ABPC) and cefditoren (CDTR), and was lower than those of cefaclor (CCL), cefdinir (CFDN) and erythromycin (EM). 2. The MIC90 of CFPN against PC-intermediate S. pneumoniae (PISP)/PC-resistant S. pneumoniae (PRSP) was equal to that of CDTR, and was lower than those of PCG, ABPC, CCL, CFDN and EM. CFPN showing strong antimicrobial activities against PISP. 3. CFPN showed strong antimicrobial activities against beta-lactamase producing and non-producing Haemophilus influenzae. The MIC90 of CFPN was stronger than those of ABPC, CCL, CFDN and EM, and was approximately equal to that of CDTR. CFPN also showed strong antimicrobial activities against strains which did not produce any beta-lactamase and were resistant to CCL with MIC of > or = 25 micrograms/ml. 4. Antimicrobial activities of CFPN against Moraxella subgenus Branhamella catarrhalis was stronger than that of ABPC and CCL, though the MIC90 of CFPN was rather high, 3.13 micrograms/ml. 5. CFPN showed strong antimicrobial activities against PISP and beta-lactamase producing H. influenzae, and also against the CCL-resistant H. influenzae indicative mutations of penicillin-binding proteins (PBPs). From those results, cefcapen-pivoxil was found to be clinically effective against community acquired respiratory tract infection.

Cephalosporins↗
PubMed1995

Safety and efficacy of cefixime in treatment of respiratory tract infections in Germany.

From October, 1993 to August, 1994, a post-marketing surveillance study enrolled 9,568 adults and children treated for respiratory tract infections with cefixime in a daily dose of 400 mg or 8 mg/kg body weight, respectively. Twice daily dosage was preferred with adults (60.4%) and children (54.4%). Bronchitis (45.5%) and otitis media (48.0%) were the most frequent indications given for cefixime use in adults and children, respectively. Bacterial analysis was done in 5.4% of adults and in 6.5% of children. With a median therapy of 6 days, cure or improvement was reported in 98.7% of adult patients and in 98.0% of children. Symptoms rapidly improved in a majority of patients. Adverse events occurred in 1.12% of adult patients and 1.92% of children. In 96.7% of all cases the dry syrup was very well or well accepted by children. In conclusion, high efficacy and low incidence of side effects make cefixime a drug of choice for treatment of respiratory tract infections.

Adult↗
PubMed1995

Do lower respiratory tract infections in early childhood cause chronic obstructive pulmonary disease?

The hypothesis that lower respiratory tract infections (LRTI) in early childhood lead to chronic obstructive pulmonary disease (COPD) in late adult life has been difficult to test. However, a unique opportunity arose when records were discovered in the counties of Hertfordshire and Derbyshire, England, that contained information about childhood LRTI recorded 60 to 70 years ago. The lung function of some men still living in these counties was examined. In Hertfordshire men, bronchitis or pneumonia in infancy was associated with reduced mean FEV1, adjusted for age and height. In Derbyshire men, pneumonia before 2 yr of age was associated with a large and highly significant reduction in mean FEV1, adjusted for age and height. These findings were independent of smoking and social class. These data support a causal relationship between LRTI in early life and subsequent COPD.

Adult↗
PubMed2001

Risk factors for respiratory tract infections in children aged 2-5 years.

OBJECTIVE: To study risk factors for respiratory tract infections (RTIs) in children aged 2-5 years. DESIGN: A questionnaire was used to chart the number of visits to doctors and the number of antibiotics courses because of RTIs during a 1-year period. The risk factors studied were age, sex, birth weight, breastfeeding, atopy, siblings, smoking and childcare. SETTING: The catchment area of Oxie health centre in southern Sweden. SUBJECTS: 190 pre-school children. MAIN OUTCOME MEASURES: Number of visits to doctors and number of antibiotics courses. RESULTS: The risk of having to consult a doctor, as well as the risk of receiving treatment with antibiotics, because of RTIs was greater among children at daycare centres than among children who were mostly at home (adjusted OR 2.78 (95% CI 1.34-5.78) and 2.73 (1.38-5.43), respectively). CONCLUSION: Attending a daycare centre is the most important risk factor for RTIs in children aged 2-5 years.

Anti-Bacterial Agents↗