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 1,009 records · Page 56Linked to original sources
PubMed2006

Upper respiratory tract infection in Thai adults: prevalence and prediction of bacterial causes, and effectiveness of using clinical practice guidelines.

BACKGROUND: Antibiotics are over-prescribed for Upper Respiratory tract Infection (URI). Uncertainty in differentiating bacterial from viral infection is the main reason for this practice. More evidence is needed to encourage proper use of antibiotics for URI. OBJECTIVES: 1) To determine the prevalence of Group A beta-hemolytic Streptococci (GAS) in adults with URI and clinical features associated with GAS infection. 2) To evaluate the effectiveness of management of adults with URI using the Clinical Practice Guideline (CPG). MATERIAL AND METHOD: A prospective study was conducted on adult out-patients with URI at Siriraj Hospital from April to October 2004. Throat swab cultures were performed in all participants. Patients were assessed and managed according to CPG adapted from principles of appropriate antibiotic use for treatment of acute upper respiratory tract infections in adults endorsed by the Centers for Disease Control and Prevention, USA. Clinical outcomes were evaluated by telephone interviews. RESULTS: Out of 292 patients enrolled, 55.5% had non-specific URI/common cold, 32.2% had pharyngitis/ tonsillitis, 11% had acute bronchitis and only 1.4% had acute sinusitis. The overall prevalence of GAS infection was 7.9%. GAS was isolated in 16% of the patients with pharyngitis/tonsillitis; and only 3.7% and 3.1% of the patients with non-specific URI/common cold and acute bronchitis respectively. Clinical manifestations associated with GAS were: 1)fever (T > or = 37.8 C), 2) exudate on the pharynx or tonsil, 3) tender cervical lymphadenopathy, and 4) absence of cough. The presence of < or = 3 of 4 criteria had high negative predictive value of 94.2%. None of the patients with non-specific URI/common cold, acute bronchitis and acute sinusitis had > or = 3 of 4 criteria. The clinical responses were not significantly different between those who received or did not receive antibiotics. Most of the patients had good clinical response by day 7. CONCLUSION: The prevalence of GAS infection in adults with URI was 7.9%. The clinical features of T > or = 37.8 C, exudate on pharynx or tonsil, tender cervical lymphadenopathy, and absence of cough were significantly found in the patients with GAS infection. Management of adults with URI using the CPG was effective and safe.

Adult↗
PubMed2006

Recurrent childhood upper respiratory tract infections do not reduce the risk of adult atopic disease.

BACKGROUND: Children of large families and those attending day care are at increased risk of respiratory tract infections, which in turn may protect against the development of allergic disease. Longitudinal studies investigating these associations beyond childhood are, however, scarce. OBJECTIVE: To investigate the association between childhood recurrent upper respiratory tract infections (URTI) and asthma, allergic rhinitis (AR) and eczema in adulthood. METHODS: A birth cohort of 1055 members followed prospectively from the ages of 2 to 21 years. Detailed information on URTI between the ages of 2 and 4 years was collected at 3 monthly intervals in a standardized interview. At the age of 8 years, a parental questionnaire regarding URTI between the ages of 4 and 8 years was used. The incidence of asthma and atopic disease at the age of 21 years was determined using a standardized questionnaire. RESULTS: Of the original cohort, 693 (66%) members completed the questionnaire. Children who experienced recurrent URTI before the age of 2 years, between the ages of 2-4 years and between ages of 4 and 8 years were not less likely to have asthma at 21 years of age than children who did not experience recurrent URTI, relative risk (RR) 0.97 (95% confidence interval (CI) 0.65-1.46), RR 1.45 (CI 0.95-2.21) and RR 1.51 (CI 0.97-2.36), respectively. Neither were recurrent URTI associated with a decreased risk of AR, nor eczema at the age of 21 years. CONCLUSIONS: Recurrent URTI in childhood did not reduce the risk of atopic disease in young adulthood.

Adolescent↗
PubMed1996

[Respiratory syncytial virus lower respiratory tract infection: our series].

The authors report 57 cases of Respiratory Syncytial Virus (RSV) lower respiratory tract infection. The diagnosis was performed by detection of specific serum antibodies of IgM class or by direct detection of RSV antigens in nasopharyngeal specimens. Most of the patients were younger than one year. No one had risk factors for severe RSV infection form. All patients recovered. The authors emphasize the difficulties to discriminate between bronchiolitis and interstitial pneumonitis on the basis of the clinical and radiological features.

English Abstract↗
PubMed1993

The relationship between nasal airway resistance and middle ear pressure in subjects with acute upper respiratory tract infection.

Middle ear pressure and nasal airway resistance were measured over 7 1/2h in 8 subjects (age 18-32) with symptomatic acute upper respiratory tract infection. The mean middle ear pressure was -13 +/- 1.5 daPa (s.e.m.) with a range between 65 to -140 daPa. The mean total nasal resistance was 0.4 +/- 0.02 Pa/cm3/s (s.e.m.) with a range between 0.20 to 1.28 Pa/cm3/s. Unilateral nasal airway resistance exhibited reciprocal fluctuations with a range between 0.18-3.60 Pa/cm3/s. The mean difference between the highest and lowest unilateral nasal resistance values for each subject was 1.48 +/- 0.22 Pa/cm3/s (n = 16). No correlation was found between unilateral nasal airway resistance and middle ear pressure. Total nasal airway resistance had an inverse correlation with middle ear pressure r = 0.32, r2 = 0.11, n = 176 (p < 0.001). The results indicate that the generation of a negative middle ear pressure in acute upper respiratory tract infection occurred in a manner consistent with intermittent obstruction of the Eustachian tube and gradual middle ear gas absorption. Rapid increases in middle ear pressure and the generation of a positive middle ear pressure were associated with nose blowing. No evidence was found to support the hypothesis that negative middle ear pressures are associated with sniffing.

Adult↗
PubMed1993

Prescription of antibiotics and prescribers' characteristics. A study into prescription of antibiotics in upper respiratory tract infections in general practice.

There is a growing concern about rational prescribing of antibiotics. That is why a secondary analysis of prescribing antibiotics in upper respiratory tract infections has been conducted by means of a nationwide study of morbidity and interventions in The Netherlands. The mean percentage of antibiotic prescriptions varied from about 20% for acute otitis media and acute upper respiratory tract infections to about 70% for sinusitis and tonsillitis. Only attitude--toward prescribing antibiotics in sore throat--and years of settlement were important predictor variables. The other characteristics studied--type of practice, list size, frequency of use of Het Farmacotherapeutisch Kompas, containing national pharmacotherapeutical guidelines, and urbanization level were not. The importance of attitude, however, was less for general practitioners who went into practice after 1975. This means that the influence of a personal characteristic as attitude might have become less influential since the introduction of vocational training for general practice.

Acute Disease↗
PubMed1986

[Respiratory tract infections--clinical results with ofloxacin].

In an open clinical trial, out-patients with respiratory tract infections were given 200 mg ofloxacin b. i. d. orally. 36 had acute bronchitis and pneumonia was diagnosed in 44. The average duration of therapy was nine days for bronchitis and 12 days for pneumonia. In the sputum of bronchitis patients, Haemophilus influenzae (n = 25), Streptococcus pneumoniae (n = 18), Branhamella catarrhalis (n = 2) and Pasteurella multocida (n = 1) were isolated. 17 H. influenzae and 12 S. pneumoniae were eliminated. All 20 S. pneumoniae strains isolated from patients with pneumonia were eliminated. A cure or improvement of clinical symptoms was seen in 32 of 36 cases of bronchitis and in 33 of 44 cases of pneumonia treated with ofloxacin.

Adult↗
PubMed2002

Natural history of serum immunoglobulin concentrations in low birth weight infants and association with respiratory tract infections.

UNLABELLED: Infections are a significant cause of morbidity and mortality among low birth weight (LBW) infants. THE AIMS OF OUR STUDY WERE: (1) to investigate whether serum antibody concentrations in 62 LBW infants (1,500-2,500 g) were normalized by 1 year of life, and (2) to determine the clinical relevance of humoral immaturity in these children during the 1st year compared to 20 appropriate-for-gestational-age (AGA) term infants. At 1 year of life, immunoglobulin serum concentrations in LBW infants were comparable to those of the control group. The incidence of respiratory tract infections during the 1st year of life was not significantly different between LBW and AGA term infants. Interestingly, we demonstrated that LBW infants with a higher frequency of reported febrile upper respiratory tract infections had more elevated serum total IgG, IgG(1), IgG(3), total IgA, and IgA(1) concentrations. Thus, infants with a birth weight of 1,500-2,500 g do not appear to have an increased risk of respiratory tract infections compared to AGA term children during the 1st year of life. Furthermore, our data suggest that especially febrile infections induce higher serum immunoglobulin concentrations in LBW infants.

Birth Weight↗
PubMed2002

Upper respiratory tract infections in general practice: diagnosis, antibiotic prescribing, duration of symptoms and use of diagnostic tests.

A diagnosis/antibiotic prescribing study was performed in 5 counties in Sweden for 1 week in November 2000. As part of this study, the characteristics and clinical management of patients with upper respiratory tract infections (n = 2899) in primary care were analyzed. Almost half of the patients were aged < 15 y and one-fifth of the patients consulted out of hours. Of all patients seeking primary care for upper respiratory tract infections, 56.0% were prescribed an antibiotic. Almost all patients who were given the diagnoses streptococcal tonsillitis, acute otitis media or acute sinusitis were prescribed antibiotics, compared to 10% of patients with common cold or acute pharyngitis. The most frequently prescribed antibiotic was penicillin V (79.2%) and this was even more pronounced out of hours, when the diagnoses otitis media and streptococcal tonsillitis were more frequently used. In patients with common cold and acute pharyngitis, the percentage who received antibiotics increased with increasing length of symptoms and increasing CRP levels. In patients with acute pharyngitis or streptococcal tonsillitis, antibiotics were prescribed less frequently provided streptococcal tests were performed. The management of patients with upper respiratory tract infections in general practice seems to be in good agreement with current Swedish guidelines. However, the study indicates some areas for improvement. The diagnosis of acute sinusitis seems to have been overestimated and used only to justify antibiotic treatment.

Acute Disease↗
PubMed2004

[Diagnostic utility of procalcitonin in community-acquired respiratory tract infections--a literature review].

Procalcitonin (PCT), the precursor protein of calcitonin, has proved to be a good marker of "acute phase" response in bacterial infections, particularly in severe and generalized one. The diagnostic utility of PCT in community-acquired respiratory tract infections is discussed in the article, particularly with regard to community-acquired pneumonia and the utilization of PCT as a monitoring and prognostic tool in the course of disease. Our review of the available literature on the subject enables us to state the following: (1) Serum PCT levels increased significantly only in bacterial respiratory tract infections. (2) Increases in serum PCT concentrations were related to the intensity of systemic inflammatory response in the course of disease; very high PCT levels were associated with poor prognosis. (3) Measurements of PCT concentrations were useful in clinical decision making as to antimicrobial treatment. (4) Testing the serum PCT level not only supplements the range of available markers of "acute phase" response, but also provides some additional information about ongoing systemic inflammation.

Acute-Phase Proteins↗
PubMed2004

Prescribing habits of general practitioners in the treatment of childhood respiratory-tract infections.

OBJECTIVE: In the present study, prescribing behavior of general practitioners (GPs) was investigated in the example of childhood upper and lower respiratory-tract infections (URTIs and LRTIs). STUDY DESIGN: A face-to-face interview was performed with 352 parents admitted to seven primary health care centers for their children diagnosed with URTI or LRTI. Prescriptions ( n=331) written by 25 GPs working at these centers were analyzed regarding legibility, format and suitability of drug choice. RESULTS: Almost 60% of parents had self-medicated their children prior to admitting to the doctor. Of the patients, 29 (8.2%) were not examined by the physicians, but were directly prescribed medicine. The physicians did not tell the diagnosis to 25.3% of the patients, did not inform 41.2% of them about the drugs and did not caution 95.7% about the side effects. Further, the physicians did not inform 42.6% of the patients about drug use instructions, did not inform 83.5% about the warnings and did not inform 81.2% about non-drug treatment. Approximately 5% of the individuals remembered the name of the drugs. Only 26.3% of the prescriptions were easily readable, and only five scripts (1.5%) contained all necessary information. The majority of the patients were given antibiotics, penicillin+beta lactamase inhibitors being the first. Paracetamol was the most frequently prescribed analgesic/antipyretic for both indications, followed by nimesulide and ibuprofen. CONCLUSIONS: The present study revealed inappropriate drug use in the treatment of respiratory-tract infections in children at the primary health care level in a district of Istanbul, Turkey. Furthermore, it has been shown that GPs practicing at primary health care centers should be trained to give adequate information about the disease and the treatment to the patients/parents to achieve good compliance and optimal drug therapy for children.

Adolescent↗
PubMed1990

Surveillance of viral respiratory tract infections over a one year period in mainly hospitalized Austrian infants and children by a rapid enzyme-linked immunosorbent assay diagnosis.

In order to obtain more information on viral respiratory tract infections in Austrian infants and children, nasopharyngeal secretions from 1432 infants and children, collected from October 1984 to October 1985, were screened for the presence of respiratory syncytial virus (RSV), adenoviruses, parainfluenza virus type 1, 2, and 3, and influenza viruses type A and B, by enzyme-linked immunosorbent assay (ELISA). The results obtained were analyzed with respect to incidence, seasonal distribution and clinical syndromes associated with the different viral pathogens investigated and also with the practicability of ELISA diagnostics over long distances. A viral etiology of acute respiratory tract infection was confirmed in 372 (26%) infants. RSV was detected in 286 (20%) of the nasal secretions and was thus the most frequently encountered agent. RSV infections occurred mainly in the winter months and were often associated with bronchitis, bronchiolitis, and pneumonia. Only sporadic infections were found with one of the other viruses investigated.

Adenoviruses, Human↗
PubMed2001

The prevalence of potential pathogenic bacteria in nasopharyngeal samples from individuals with a respiratory tract infection and a sore throat--implications for the diagnosis of pharyngotonsillitis.

BACKGROUND: Treatment failure in patients with pharyngotonsillitis after a traditional course of penicillin V is a common finding. Several factors have been proposed to explain the failure rate, but the presence of aetiological agents other than group A beta-haemolytic streptococci has attracted little attention. OBJECTIVES: The aim of the present study was to investigate if a nasopharyngeal sample could suggest the aetiology of a sore throat in patients with a respiratory tract infection. METHODS: The prevalence of potentially pathogenic bacteria (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) in nasopharyngeal samples from 618 healthy individuals was compared with that from 108 patients with a respiratory tract infection and a sore throat. RESULTS: The prevalence of H.influenzae was higher in patients with a sore throat than in healthy individuals of the same age. For the adult patients with a sore throat, the prevalence was 27.5% compared with 2.7% for the healthy carriers (P < 10(-7)). The corresponding figures for schoolchildren were 31.3% versus 6.1% (P = 0.004) and for pre-school children 37.8% versus 13.2% (P = 0.0003). CONCLUSIONS: If H.influenzae is found in a nasopharyngeal sample from a patient with a respiratory tract infection and a sore throat, it might be the aetiological agent.

Adolescent↗
PubMedDate not supplied

Open clinical trial of roxithromycin in patients of Plateau Hospitals, Jos in upper and lower respiratory tract infections.

An open clinical study to assess the efficacy and tolerance of Roxithromycin 150 mg twice daily was carried out amongst Nigerian patients with upper and lower respiratory tract infections at Plateau Hospital Jos. Twenty-two patients aged between 13 and 86 years comprising of twelve women, seven men and three children completed the study. 18 (81.8%) had bronchopulmonary infections, 3 (13.6%) had tonsillitis and 1 (4.6%) had otitis media. Pathogens isolated included streptococcus Pneumonia (22.7%), Streptococcus pyogenes (13.6%), Bramhella Catarrhalis (9.1%), Haemophilus influenzae (9.1%), Staphylococcus Aureus (4.6%), Klebsiella species (4.6%), Pseudomonas Aeruginosa (4.6%). There was 88.2% bacteriological cure and patients responded fast, with no major adverse reactions. Roxithromycin is therefore concluded to be an effective well tolerated drug for treatment of respiratory tract infections in Nigerians.

Adolescent↗
PubMed2003

Reduction in antibiotic prescribing for respiratory tract infections is needed!

In general practice, approximately 25% of consultations are related to infectious diseases. The emergence and spread of resistant bacteria are related to antibiotic use on an individual and on a community level. Antibiotic prescribing differs profoundly from one European country to the next, though there is no evidence of differences in the prevalence of infectious diseases. Most respiratory tract infections are self-limiting conditions, and recent evidence shows that antibiotics only slightly modify the course of most respiratory tract infections. The general practitioner should focus on patients with more severe symptoms who might benefit more from antibiotic treatment. In general, antibiotics should be prescribed for acute pneumonia. In addition, we may offer antibiotics to a selected group of patients with more severe symptoms of maxillary sinusitis, pharyngotonsillitis and acute exacerbation of chronic obstructive pulmonary disease/chronic bronchitis. In the diagnostic procedure, rapid tests of Streptococcus pyogenus and C-reactive protein may be valuable in carefully selected cases. Penicillins (penicillin V, amoxycillin) should be the first choice in most respiratory tract infections. Larger studies in general practice are needed to analyse the impact of antibiotic prescribing on morbidity, the occurrence of rare complications and spread of resistance. The greatest challenge will be to implement current knowledge in daily praxis.

Anti-Bacterial Agents↗
PubMed1995

[Recurrent respiratory tract infections].

On the occasion of a treatment of frequent infections of the upper respiratory tract an antibody deficiency syndrome was noticed in a 32-year-old female patient. Further investigations revealed a variable immunodeficiency syndrome, a disease belonging to the primary humoral immune defects and presenting with multiple clinical manifestations. Leading symptoms, however, are recurring respiratory infections that may lead to bronchiectasis. Therapy consists in the prevention of infections by periodical intravenous substitution with 7-S immunoglobulins and opportune prescription of antibiotics.

Adult↗
PubMed1976

Levamisole in prevention of recurrent upper-respiratory-tract infections in children.

70 children with chronically relapsing mild-to-severe upper-respiratory-tract infections during autumn and winter participated in a six month double-blind placebo-controlled trial: 38 of them received about 1-25 mg/kg of levamisole twice daily for two consecutive days every week, the others were given placebo. During each of the three trial periods, levamisole proved superior to placebo in that it significantly reduced the number, the duration, and the severity of the infections. Moreover, in the group treated with the higher dose (i.e. greater than 2-5 mg/kg/day), the superiority of levamisole to placebo was much more clear-cut. No drug-related side-effects were reported.

Adolescent↗
PubMed2005

[Recurrent lower respiratory tract infection in children: when and how should they be investigated?].

Children with recurrent lower respiratory tract infections are often a challenge for their physicians. This article reviews the differential diagnosis of recurrent cough, bronchopneumonia and/or pneumonia in children and emphasizes on the necessity of preventing long-term complications of these infections. It also suggests a step-wise immunological work-up, which includes investigating a possible immune maturation delay or deficiency which could explain these symptoms. This work-up focuses on measuring antibody responses to pneumococci, followed by immunization when necessary, to rule out B cell dysfunction. Finally, this article also describes an upcoming study in Switzerland which will evaluate in 2005 the clinical and immunological outcome of these young patients.

Antibodies, Bacterial↗
PubMed1999

Chlamydia trachomatis (mouse pneumonitis strain) induces cardiovascular pathology following respiratory tract infection.

Chlamydia, especially Chlamydia pneumoniae, infection is closely associated with human cardiovascular diseases. Thus far, however, few experimental studies have been carried out to investigate whether natural C. trachomatis infection can induce cardiovascular pathological changes. In this article, we report that pulmonary infection with C. trachomatis mouse pneumonitis strain (MoPn) can induce myocardial and perivascular inflammation and fibrosis in C57BL/6 mice. The pulmonary MoPn infection appeared to be disseminated systemically, because chlamydial antigens were readily detectable in multiple organs including the cardiovascular tissues. In addition, gamma interferon gene knockout mice with a C57BL/6 genetic background showed significant endocarditis and pancarditis characterized by vegetation in aortic valves, interstitial and pericardial inflammatory cellular infiltration, and growth of the organisms in the heart following respiratory tract MoPn infection. The results indicate that C. trachomatis can induce cardiovascular diseases following respiratory tract infection and suggest that murine MoPn respiratory tract infection may be a useful experimental model for investigating cardiovascular diseases caused by chlamydial infection.

Animals↗