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 991 records · Page 55Linked to original sources
PubMed2002

Antibiotic prescribing in ambulatory care settings for adults with colds, upper respiratory tract infections, and bronchitis.

BACKGROUND: Imprudent prescribing of antibiotics for patients with colds, upper respiratory tract infections (URIs), and bronchitis may contribute to antibiotic resistance and waste economic resources. OBJECTIVE: The purpose of this study was to determine the antibiotic prescribing rate for adults diagnosed with colds, URIs, and bronchitis in 1996 and to compare these rates with those reported for 1992. METHODS: This was a retrospective, cross-sectional analysis of a US government data base of ambulatory physician practices. The number of adults ( > or = 18 years of age) with a diagnosis of cold, URI, or bronchitis and the percentage receiving antibiotics were determined from the 1996 National Ambulatory Medical Care Survey (NAMCS). The antibiotic prescribing rate was the main outcome measure. RESULTS: In 1996, approximately 13.9 million office visits resulted in a primary diagnosis of cold, URI, or acute bronchitis; of these visits, 46%, 47%, and 60%, respectively, resulted in the prescribing of an antibiotic. The respective rates in 1992 were 51%, 52%, and 66%. The rates of antibiotic prescribing were 12% to 16% higher when all drugs, not just the first drug listed in the NAMCS database, were analyzed. In 1996, antibiotic prescribing rates for persons 45 to 64 years of age and persons > 64 years of age were significantly lower than for those aged 18 to 44 years. CONCLUSIONS: The rates of potentially inappropriate antibiotic prescribing decreased modestly from 1992 to 1996; however, previous rates may have been underestimated. The antibiotic prescribing rates for colds, URIs, and acute bronchitis may be as high as 61%, 63%, and 72%, respectively, when all drug information is analyzed. Antibiotics are over-prescribed, which may increase antibiotic resistance and waste health care resources.

Adolescent↗
PubMed1993

A single-blind, randomised, comparative study of clarithromycin and amoxycillin suspensions in the treatment of children with lower respiratory tract infections.

One hundred and forty-five children with signs and symptoms of lower respiratory tract infections were entered into this multicentre, General Practice, investigator-blind study, designed to demonstrate equivalent efficacy between clarithromycin and amoxycillin suspensions. Seventy one children were randomised to treatment with clarithromycin suspension 7.5 mg/kg bodyweight twice daily and 74 to treatment with amoxycillin suspension 125 mg (bodyweight < 25 kg) or 250 mg (bodyweight > or = 25 kg) three times a day according to bodyweight. Duration of therapy was 5-10 days as determined by the investigator. Clinical evaluations were performed pretreatment, during treatment and post-treatment within 72 hours of cessation of therapy. Fifty two children in the clarithromycin group and 57 in the amoxycillin group were clinically evaluable. Both study medications were effective and there were no significant differences between the groups with respect to clinical cure rate (60% for clarithromycin and 63% for amoxycillin), clinical success rate (cure plus improvement, 96% for clarithromycin and 95% for amoxycillin) or rate of resolution of clinical signs and symptoms in clinically evaluable patients. The intention to treat analysis for all patients entered similarly showed no significant differences in efficacy. The two treatment groups did not differ significantly with respect to incidence or severity of adverse events which were generally mild and associated with the gastrointestinal system. Therapy was withdrawn because of adverse events in three children on clarithromycin and one on amoxycillin. Bacteriological cure rates could not be determined because of an insufficient number of evaluable pre-treatment sputum samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Amoxicillin↗
PubMed2003

Elevations of local leukotriene C4 levels during viral upper respiratory tract infections.

BACKGROUND: One potential mechanism by which respiratory viruses trigger illness and complications is via the local elaboration of inflammatory mediators. OBJECTIVE: To determine whether there is an increase in local leukotriene C4 (LTC4) levels during experimental infection with influenza A virus (FLU), rhinovirus (RV), or respiratory syncytial virus (RSV). METHODS: Healthy adults were intranasally inoculated with a safety-tested strain of FLU (n = 29), RV (n = 16), or RSV (n = 21). Nasal lavage samples were collected, symptoms were recorded, and expelled nasal secretions were weighed before and then daily after challenge. Lavage samples were submitted for viral culture and assayed for LTC4 levels by radioimmunoassay. Serum antibody titers to the challenge viruses were assayed at baseline and 21 days after challenge. RESULTS: All subjects were infected as evidenced by viral shedding and/or seroconversion. Following infection, significant increases (P < 0.05 by analysis of variance) in LTC4 levels were measured for each virus. Furthermore, there was a temporal association between the local LTC4 levels and the development of illness. CONCLUSIONS: The results of this study, which used an adult experimental model, demonstrate elevations in locally produced LTC4 during respiratory infection with FLU, RV, and RSV. Future studies using antileukotriene agents may help elucidate the precise role of leukotrienes in mediating disease expression.

Adolescent↗
PubMed1991

Management of upper respiratory tract infection in Dutch general practice.

A questionnaire, sent to a 10% random sample of Dutch general practitioners (n = 635) included descriptions of four cases of upper respiratory tract infections (acute tonsillitis, recurrent tonsillitis, acute otitis media and sinusitis). This was used to study the general practitioners' management of upper respiratory tract infections. A total of 376 doctors responded (59%). The majority of general practitioners would prescribe antibiotics for sinusitis (80% of respondents) but only 29% would prescribe antibiotics for acute otitis media. For acute tonsillitis and recurrent tonsillitis the proportions were 52% and 59%, respectively. The low prescription rate for acute otitis media was in accordance with national standards, such as the standard of the Netherlands college of general practitioners. A penicillin (phenoxymethylpenicillin or phenethicillin) was most likely to be selected for the two types of tonsillitis, amoxycillin for acute otitis media and doxycycline for sinusitis. Other antibiotics such as erythromycin, other tetracyclines and ampicillin, were seldom selected. Most respondents would prescribe antibiotics for seven days, but there was considerable variation. The influence of the characteristics of the general practitioners and their practices on their antibiotic prescribing was small. Only type of practice correlated with antibiotic treatment, in that general practitioners in single-handed practices would prescribe antibiotics more often than their colleagues in health centres. Among those who would prescribe symptomatic treatment nearly all would prescribe nosedrops for acute otitis media and sinusitis. Eighty five per cent of the respondents would refer the patient with recurrent tonsillitis, while 10% would refer the patient with acute otitis media. The results suggest that some aspects of the prescribing behaviour of Dutch general practitioners might be improved.

Family Practice↗
PubMed1983

Occurrence of Haemophilus influenzae strains in children with respiratory tract infections.

In the time period from February 1980 to October 1981, 179 children with upper respiratory tract infections and 67 healthy controls were investigated in Warsaw. The clinical condition of the studied children, the types of the obtained H. influenzae strains and their sensitivity to the antibiotics and sulphamides used most frequently in clinical practice were analyzed.

Adolescent↗
PubMed2005

Prognostic factors for serious morbidity and mortality from community-acquired lower respiratory tract infections among the elderly in primary care.

BACKGROUND: Uncertainty about the prognosis of lower respiratory tract infections (LRTI) hinders optimal management in primary care. OBJECTIVE: We determined prognostic factors for a severe complicated course of LRTI among elderly patients in primary care. METHODS: In a retrospective clinical database study we examined 455 patients with a first LRTI episode; 226 with physician-diagnosed acute bronchitis or lung exacerbations and 229 with pneumonia. Multivariate logistic regression analysis was used to assess independent associations of the potential predictors with the endpoint. RESULTS: Occurrence of the combined endpoint 30-day home-treated complications from LRTI (4.4%) or hospitalisation (4.6%), or all-cause mortality (5.3%) was 14.3%. In a logistic regression model, increasing age [odds ratio (OR) 1.04; 95% confidence interval (95% CI) 1.00-1.08], male sex (OR 3.12; 95% CI 1.66-5.87), heart failure (OR 5.14; 95% CI 2.33-11.34), stroke or dementia (OR 3.36; 95% CI 1.18-9.58), use of antidepressants or benzodiazepines (OR 1.89; 95% CI 1.02-3.52) and a diagnosis of pneumonia (OR 4.24; 95% CI 2.17-8.28) were independent predictors. CONCLUSION: GPs need to be aware of readily available prognostic factors that can be used in primary care to complement physical examination and laboratory data in LRTI to guide preventive and therapeutic management decisions.

Aged↗
PubMed1988

[Clinical examination of S 6472 (sustained release preparations of cefaclor on chronic respiratory tract infection].

Clinical evaluation of S 6472 (sustained release preparations of cefaclor), a granule form of cefaclor, was performed in 20 patients with chronic respiratory tract infections. The patients subjected to the study consisted of 11 males and 9 females with ages between 44 and 76 years. S 6472 was given orally to each patient in a daily dose of 750 mg in 2 divided portions. The duration of administration was 3 days in 1 case, 7 days in 11 cases, 11 days in 3 cases and 14 days in 5 cases. A total of 5 strains including 2 strains of Staphylococcus aureus, and 1 strain each of Staphylococcus epidermidis, Streptococcus pyogenes and Streptococcus pneumoniae were identified from sputum samples before the administration of the drug. All strains were eradicated but, instead 2 strains, 1 strain each of Enterobacter cloacae and Pseudomonas aeruginosa appeared after the therapy. The clinical efficacy rate was 95.0% (19/20): Excellent in 5 cases, good in 14 cases and fair in 1 case. No side effects were observed, but eosinophilia was observed in 1 case. From the above results, it appeared that S 6472 was effective, safe and useful agent for the treatment of acute exacerbation of chronic respiratory tract infections.

Administration, Oral↗
PubMed1998

Role of intracellular pathogens in respiratory tract infections.

Recent epidemiologic studies have shown that in patients with acute respiratory tract infection, intracellular pathogens, and particularly Mycoplasma pneumoniae and Chlamydia pneumoniae, might be involved more frequently than was previously assumed. In addition, newer investigations, such as specific culture or polymerase chain reaction (PCR), when systematically performed in patients with asthma, chronic obstructive pulmonary disease and even cystic fibrosis, frequently detect Mycoplasma pneumoniae or Chlamydia pneumoniae in those individuals. The significance of such detection (chronic bronchial infection?) and the role that these intracellular pathogens might play in the natural history of chronic respiratory diseases remain to be evaluated.

Journal Article↗
PubMed1983

[Pharmacological evaluation of an ampicillin suppository (KS-R1) in acute respiratory tract infection in children: a comparison with an oral form of ampicillin].

A comparative well-controlled study was performed to evaluate the efficacy and tolerability of ampicillin rectal suppository (KS-R1) compared with those of oral form of ampicillin (ABPC) against acute respiratory tract infections in pediatric field. KS-R1 at the dose of 125 mg X 4/day of ABPC in potency, or the oral form at the same dosage, was given to 166 cases of patients with acute respiratory tract infection due to Streptococcus pyogenes, Streptococcus pneumoniae or Haemophilus influenzae for 7 days, as a rule. The clinical efficacy rates evaluated in 151 cases (KS-R1 group in 77 cases, oral group in 74 cases) on standard criteria of committee members were 88.3% for the KS-R1 group and 86.5% for the oral group, respectively. There was no significant difference between 2 groups. Evaluation by stratification according to the diagnosis showed that the efficacy rates for the KS-R1 group and for the oral group were 87.5% and 85.0% against pharyngitis, 90.5% and 90.0% against tonsillitis and 84.2% and 78.6% against bronchitis, respectively. None of them showed significant difference between 2 groups. The bacteriological effect was evaluated in 55 cases (KS-R1 group in 33 cases, oral group in 22 cases), and disappearance rate was 93.9% for the KS-R1 group and 95.5% for the oral group, showing no significant difference. Side effect including subjective and objective symptoms were strictly evaluated in 163 cases (KS-R1 group in 83 cases, oral group in 80 cases), but the incidence rate which was 22.9% for the KS-R1 group and 23.8% for the oral group showed no significant difference. The above results indicate that against acute respiratory tract infections in pediatric field, KS-R1 possesses clinical efficacy and safety similar to the oral form of ABPC, and that it is a useful suppository.

Acute Disease↗
PubMed1996

Serum alpha-interferon in lower respiratory tract infections of children.

BACKGROUND: Serum alpha-interferon (IFN-alpha) concentrations are high in some children with viral meningitis and other viral infections. We have tried to assess the utility of determining serum IFN-alpha concentrations as a marker of acute viral respiratory infections. METHODS: Measurement of IFN-alpha via a biologic assay on Madin-Darby bovine kidney cells was performed in 138 patients with lower respiratory tract infection in whom a pathogen was identified. RESULTS: Serum IFN-alpha was detectable at the early stage of respiratory infections in the era of 59 of 75 (78.7%) of patients with a viral infection and in 4 of 63 (6.3%) of those with bacterial infection (P < 0.001). In the 4 patients with positive IFN-alpha and bacterial infection, a concomitant viral infection was found. The production of IFN-alpha is independent of age, and detectable levels are found in young infants, including the first 3 months of life, and in children with an acute viral disease. CONCLUSION: This test could be useful in distinguishing between bacterial and viral origins in lower respiratory tract infection (the specificity was 94% and the sensitivity was 79%) and could help guide the use of antibiotics, but more rapid techniques, available in a matter of hours, are required.

Acute Disease↗
PubMed2001

Aetiology of respiratory tract infections: clinical assessment versus serological tests.

Two hundred and fifty ambulatory patients with febrile respiratory tract infections were included in a prospective study, aimed at determining the reliability of physicians judgements relating to the aetiology of the infection. Compared with advanced serological testing, physicians' judgements for a bacterial/atypical, rather than viral, aetiology had a negative predictive value of 60% and a positive predictive value of only 50%. We conclude that physicians' ability to assess whether the infectious aetiology of RTI is viral or bacterial/atypical is low and no more reliable than tossing a coin.

Adult↗
PubMed1975

Comparative study on the use of co-trimoxazole and tetracycline in the treatment of lower respiratory tract infections.

A double-blind trial was carried out on 116 patients with lower respiratory tract infection and systemic manifestations. One group received co-trimoxazole (480 mg. trimethoprim and 2,400 mg. sulphamethoxazole daily), and the other group received 2 g. tetracycline daily. The trial, as judged by clinical improvements, the reduction of purulent sputum and the rate of eradication of infection, showed a better result with co-trimoxazole. The incidence of side-effects were higher in the group receiving tetracycline compared with those receiving co-trimoxazole.

Drug Combinations↗
PubMed2003

[Efficacy and safety assessment program of fusafungin in the treatment of acute upper respiratory tract infections in adults (PROFIL): multicenter study in Poland].

The aim of the study was evaluation of efficacy and safety of new form of fusafungine in the treatment of upper respiratory tract infections in adults. The study comprised 1639 patients treated in 288 centres in Poland. Fusafungine (Bioparox) was administered 4 applications to the pharynx and/or to the nose every 4 hours during the day. The result of treatment were observed after 5 days. Signs and symptoms of infections were observed both by the physician and by the patients. In 1188 patients regression of signs and symptoms was observed after 5 days of treatment both in bacterial and viral infections. Fusafungine in a new (without freon) form is efficacy and safety drugs in the treatment of upper respiratory tract infections in adults.

Acute Disease↗
PubMed2002

Management of lower respiratory tract infections by French general practitioners: the AIR II study. Analyse Infections Respiratoires.

The Analyse Infections Respiratoires (AIR) II study is a prospective, multicentre survey of the management of lower respiratory tract infections in patients aged 15-65 yrs by general practitioners (GPs) in France. To obtain real-time data recording, practitioners were required to submit an anonymous copy of their drug prescriptions. They were then interviewed over the telephone about the patients' sociodemographic data, signs and symptoms, as well as their presumptive diagnosis and the investigations they had decided upon. GPs (n=3,144) reported 5,469 evaluable cases. Pneumonia accounted for 9.6% of diagnoses, acute exacerbations of chronic bronchitis 14.9% and acute bronchitis 72.5%. The symptomatology covered an extremely wide range of clinical features, which, although statistically different in terms of incidence, overlapped to a large extent across diagnoses. By contrast, hospitalization, investigations or referral to a specialist were much more prevalent in pneumonia, although still very infrequent in general terms (0.5, 1.2 and 10.8%, respectively). Antibiotics were prescribed in 96.5% of patients, with minor differences between diagnoses. However, other medications such as nonsteroid, anti-inflammatory drugs, steroids, nonspecific antitussives and bronchial liquefiers accounted for two-thirds of the prescriptions. This study demonstrates the lower respiratory tract infections encountered by general practitioners are usually mild. However, antibiotic prescription was more systematic than in previous studies and the prescription of nonspecific symptomatic treatments was twice as frequent. General practitioners did not perform additional examinations or refer on a regular basis. There was a high prescription rate for symptomatic treatment.

Adult↗
PubMed1983

Cephalexin in the treatment of upper respiratory tract infections.

Cephalexin, a semisynthetic cephalosporin antibiotic, has wide clinical application in respiratory infections of children and adults. In pharyngitis and tonsillitis due to beta-haemolytic streptococci, it is comparable to penicillin, cyclocillin, and cephaloglycin, as measured by clinical response, bacteriological cure rate, and incidence of relapse and reinfection. In otitis media, it is effective at dosages of 50-100 mg/kg/day except in those infections caused by Haemophilus influenzae, in which there is failure in 50% of the cases. In other infections of the upper respiratory tract, it appears to be effective except, again, in those caused by H. influenzae. Dosages of 1-2 g/day have been used in adults and 20-100 mg/kg/day in children. Adverse effects, mostly gastrointestinal upsets, rash, and urticaria, have been relatively infrequent and have not required discontinuance of the drug.

Adult↗
PubMed1992

[Clinical efficacy of ceftriaxone when administered once daily for respiratory tract infections in patients with advanced ages].

Ceftriaxone (CTRX), a new third generation cephalosporin, was investigated upon once daily administration for its clinical efficacy and safety on respiratory tract infections in patients with advanced ages. The results are summarized as follows: 1. Clinical responses to CTRX of 48 cases of advanced age patients with respiratory tract infections were good with an efficacy rate of 89.6%. 2. Adverse reactions to CTRX were mainly exanthema in 7 cases (14.6%). 3. Serum levels of CTRX were determined in 4 cases after intravenous drip infusion of 2 g CTRX. Serum levels were analyzed by one-compartment model. There was no evidence of accumulation of CTRX in the patients with advanced ages.

Aged↗
PubMed2001

Community-acquired lower respiratory tract infections: etiology and treatment.

The current therapy for community-acquired lower respiratory tract infections is often empiric, usually involving administration of a beta-lactam or macrolide. However, the increasing prevalence of antibiotic resistance in frequently isolated respiratory tract pathogens has complicated the antimicrobial selection process. This review will discuss the incidence of various respiratory pathogens, as well as update the clinician on the various antimicrobial alternatives available, with particular emphasis on the role of the newer fluoroquinolones in the treatment of acute exacerbations of chronic bronchitis and community-acquired pneumonia.

Anti-Bacterial Agents↗