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PubMedDate not supplied

Drug resistant Haemophilus influenzae from respiratory tract infection in a tertiary care hospital in north India.

Haemophilus influenzae is an important respiratory pathogen. Emergence of resistance to various antibiotics is a major problem in patient management. A total of 90 strains of H. influenzae were characterized from specimens obtained from patients of acute respiratory tract infection; 13 (14.4%) belonged to type beta. On biotyping, 90% strains belonged to biotype II. The frequency of resistance to various antibiotics was as follows: cotrimoxazole 33.3% ampicillin 21.1%, cephalexin 7.8%, chloramphenicol 7.8%, ciprofloxacin 2.5% erythromycin and tetracycline 5% each. All the ampicillin-resistant strains produced beta-lactamase as detected by nitrocefin disc method. None of the strains exhibited resistance to cefaclor and third generation cephalosporins. The present study showed emergence of variable resistance to ampicillin, cotrimoxazole and other antibiotics. It is important for the clinical microbiology laboratory to monitor drug resistant strains for instituting appropriate antibiotic therapy of respiratory infections due to H. influenzae.

Adolescent↗
PubMed2006

Acute respiratory tract infections among Hajj medical mission personnel, Saudi Arabia.

OBJECTIVES: To estimate the prevalence of acute respiratory tract infections (ARI) among 250 personnel serving in a Hajj medical mission, Al-Hada and Taif Armed Forces Hospitals, during the 2005 season and to determine the effectiveness of protective measures, including influenza vaccination, for these infections. METHODS: This was a nested case-control study. A questionnaire was distributed to the study cohort two weeks after the Hajj period and was self-administered by all recruited subjects. In addition, the medical records of study subjects were reviewed at Al-Hada Hospital for the same period in order to document ARI. RESULTS: The attack rate for ARI among study subjects during Hajj season or within two weeks of returning was 25.6% (64/250). Logistic regression analysis of factors related to acquiring ARI revealed that contact with pilgrims imposed an extremely high risk of infection (adjusted OR 13.2, 95% CI 1.5-117.6). Moreover, non-use of alcohol-based hand disinfection carried a more than 8-fold risk of acquiring ARI compared to those who always used alcohol for hand disinfection (adjusted OR 8.4, 95% CI 2.2-32.2). Smoking was also a predictor of ARI in our cohort and influenza vaccination was associated with a 30% reduction in ARI compared to unvaccinated subjects, although this finding was not statistically significant. Unexpectedly, the logistic regression model showed that Saudi nationals were three times more likely to acquire ARI than non-Saudis (adjusted OR 3.1, 95% CI 1.2-8.4). CONCLUSIONS: The common practice among pilgrims and medical personnel of using surgical facemasks to protect themselves against ARI should be discontinued and regular use of alcohol-based hand scrubs should be more vigorously encouraged. Further research is needed to evaluate the protective value of N95 facemasks against ARI during the Hajj period.

Acute Disease↗
PubMed1989

Cefetamet pivoxil in paediatric patients suffering from lower respiratory tract infections.

A prospective, randomized comparative trial was carried out in 31 children suffering from lower respiratory tract infections, mainly bronchopneumonia or pneumonia. Twenty-one children received oral cefetamet pivoxil in a dose of 20 mg/kg/day (10 children) or 40 mg/kg/day (11 children), and 10 children 30 mg cefaclor/kg/day for 7 days. Clinical signs and symptoms, i.e. fever, dyspnoea, altered breath sounds and cough, subsided during treatment with both cefetamet pivoxil treatment doses in all patients. All X-ray findings and blood leucocytosis normalized, while 1 out of the 10 children to whom 30 mg cefaclor/kg/day was administered deteriorated from bronchopneumonia to pneumonitis during treatment. Treatment was stopped due to vomiting in 1 patient receiving the 40 mg cefetamet pivoxil/kg/day dose.

Adolescent↗
PubMed2000

In vitro activity of newer fluoroquinolones for respiratory tract infections and emerging patterns of antimicrobial resistance: data from the SENTRY antimicrobial surveillance program.

In 1997, an international surveillance program, SENTRY Antimicrobial Surveillance Program, was initiated with the aim of tracking the emergence of antimicrobial resistance worldwide. Results from reference antimicrobial susceptibility testing of bacterial pathogens (from bloodstream, inpatient and outpatient lower respiratory tract, urinary tract, and skin and soft-tissue infections) were included in an extensive database used to define antimicrobial resistance patterns throughout the world. On the basis of 1997-1999 test results from the Americas, fluoroquinolones continue to demonstrate potent in vitro activity against Enterobacteriaceae and important pathogens (Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and atypicals) that cause community-acquired respiratory tract infections. At published breakpoint concentrations, gatifloxacin, levofloxacin, sparfloxacin, grepafloxacin, trovafloxacin, and ciprofloxacin inhibited approximately 100% of H. influenzae isolates, including those that demonstrated resistance to beta-lactams and macrolides. Fluoroquinolones were also active against numerous other gram-negative bacilli and demonstrated high activity against S. pneumoniae and beta-hemolytic or viridans group streptococci. New fluoroquinolones maintain activity against penicillin-resistant strains of S. pneumoniae, with a low overall resistance in this species, even among the most recent (1999) clinical isolates. The SENTRY Antimicrobial Surveillance Program will continue to monitor the antibacterial activity of these newer agents throughout the world, to identify emerging resistant strains and to facilitate possible intervention strategies as these newer compounds are used in the clinic setting.

Anti-Infective Agents↗
PubMed1993

Efficacy, safety and tolerance of parenteral piperacillin/tazobactam in the treatment of patients with lower respiratory tract infections.

An open, non-comparative multicentre study was conducted at 36 sites in six countries to test the efficacy and safety of piperacillin/tazobactam in the therapy of lower respiratory tract infections. Piperacillin 4 g and tazobactam 500 mg were administered intravenously every 8 h for a minimum of five days. Two hundred and thirty patients were enrolled: 133 were evaluable for clinical efficacy and 106 for bacteriological efficacy. The clinical response was favourable in 96% of evaluable patients and the bacterial eradication rate was 93%. Nine patients (4%) had severe adverse events related to piperacillin/tazobactam and requiring discontinuation of therapy. In this study piperacillin/tazobactam was an effective and safe drug in the treatment of hospitalized patients with lower respiratory tract infection caused by sensitive organisms.

Adolescent↗
PubMed2002

Otolaryngological surgery and upper respiratory tract infections in children: an epidemiological study.

The objective of the study was to assess the occurrence of different procedures of upper airway surgery and estimate their relationship to specific upper respiratory tract infections and constitutional factors. In a population-based cross-sectional study in Oslo. Norway, of 3,763 preschool children 3 to 4 years of age, the otolaryngological surgeries adenoidectomy, tonsillectomy, myringotomy, ventilation tube insertion, and combinations of these were the outcome measures. The results showed that by 4 years of age, 13% (n = 501) had undergone operation, and approximately two thirds of the operations involved middle ear surgery. Although surgery was related to the occurrence of upper respiratory tract infections, the type of surgery was not related to the specific infection. In the children with operations, the occurrence of recurrent otitis media (> or = 3 infections in the previous 12 months) was almost fivefold higher than in children without operations (adjusted adds ratio [ORadj] = 5.19 [3.15 to 8.54]). A low level of maternal education (ORadj = 1.61 [1.05 to 2.7] compared to the group with a high level of education) and atopy on the part of the child (ORadj = 1.58 [1.20 to 2.07]) increased the probability for upper airway surgery independently of the experience of infections. In conclusion, early pediatric otolaryngological surgery is common. The decisions for surgical treatment vary substantially and are not closely related to the specific infections. The influence of other factors such as maternal education indicates that decisions for surgery are not entirely based on medical evidence.

Adenoidectomy↗
PubMedDate not supplied

The Viriato Study: update of antimicrobial susceptibility data of bacterial pathogens from community-acquired respiratory tract infections in Portugal in 2003 and 2004.

The Viriato Study is a nationwide, prospective, multicenter surveillance study of the antimicrobial susceptibility of bacterial pathogens commonly associated with community-acquired respiratory tract infections in Portugal. In 2003 and 2004 a total of 2945 isolates was recovered in the 29 laboratories that participated in the study. Testing was undertaken in a central laboratory. Of the 513 Streptococcus pyogenes strains isolated from patients with acute tonsillitis all were susceptible to penicillin and other beta-lactams but 18.9% were resistant to erythromycin, clarithromycin and azithromycin. The M phenotype dominated (67%), conferring resistance to erythromycin (MIC90 = 16 mg/L), clarythromycin and azithromycin, but susceptibility to clindamycin (MIC90 = 0.094 mg/L). From patients with lower respiratory tract infection 1,300 strains of Streptococcus pneumoniae, 829 of Haemophilus influenzae, and 303 of Moraxella catarrhalis were studied. Among S. pneumoniae isolates 18.4% were resistant to penicillin (3.5% showing high-level resistance), 7.1% to cefuroxime, 0.5% to amoxicillin and amoxicillin/clavulanate, 18.8% to erythromycin, clarithromycin and azithromycin, 14.9% to tetracycline, 16.5% to co-trimoxazole, and 0.4% to levofloxacin. Beta-lactamases were produced by 10.0% of H. influenzae and 96.4% of M. catarrhalis. In H. influenzae resistance to clarithromycin was 5.5% and to co-trimoxazole was 13.4%. Most strains were susceptible to amoxicillin/clavulanate, cefuroxime, azithromycin, tetracycline and ciprofloxacin. In M. catarrhalis resistance to co-trimoxazole was 27.1% and to tetracycline 1.0%. All strains were susceptible to amoxicillin/clavulanate, cefuroxime, clarithromycin, azithromycin and ciprofloxacin. Penicillin was the most active antimicrobial agent against S. pyogenes and amoxycillin/clavulanate and the quinolones the most active in vitro simultaneously against S. pneumoniae, H. influenza and M. catarrhalis.

Anti-Bacterial Agents↗
PubMedDate not supplied

Management of upper respiratory tract infection by family doctors.

The prescribing behaviour of family doctors in Hong Kong towards upper respiratory tract infections (URTIs) and the factors that might affect such behaviour were studied. All 1016 members of the Hong Kong College of Family Physicians were sent a postal questionnaire. A total of 730 family doctors completed the questionnaire, with an overall response rate of 71.8%. Doctors who were older, more senior, or in private practice were more likely to think antibiotics were useful for URTIs and to prescribe them. These doctors were also more likely to think their patients would expect antibiotics from them. Postgraduate vocational training in general practice/family medicine helped make family doctors think fewer patients would expect antibiotics from them but did not affect their perception of the usefulness of antibiotics for URTIs. Our results showed that doctors with certain characteristics were more likely to prescribe antibiotics for URTIs and these doctors may be targeted for continued medical education.

Adult↗
PubMed1996

Lower respiratory tract infections among Norwegian infants with siblings in day care.

OBJECTIVES: The purpose of this study was to assess the role of siblings in day care as a determinant of infants' risk of lower respiratory tract infections. METHODS: A total of 3238 children (86%) out of 3754 Oslo, Norway, newborns recruited in 1992/93 were followed for 1 year. RESULTS: In logistic regression analysis, the risk of infection was increased in (1) infants with one or more siblings compared with infants without siblings (adjusted odds ratio [OR] = 2.3; 95% confidence interval [CI] = 1.84, 2.85) and (2) infants with one or more siblings in day care compared with infants with siblings not in day care (adjusted OR = 1.7; 95% CI = 1.21, 2.26). CONCLUSIONS: The results suggest that siblings in day care outside the home increase infants' risk of lower respiratory tract infections.

Cohort Studies↗
PubMed1997

Cefodizime once daily in the treatment of lower respiratory tract infections.

Cefodizime (CAS 69739-16-8, HR 221) is a new third-generation cephalosporin with pharmacokinetic properties that make it suitable for once-daily administration in the treatment of lower respiratory tract infections (LRTI). Ninety-nine adult hospitalized patients (66 males, 33 females, median age 57.5 years) received a once-daily injection of 2 g cefodizime for LRTI. Median treatment duration was 8 days. Forty-two patients received cefodizime intravenously and 57 intramuscularly. Indications for treatment were as follows; primary lobar pneumonia (n = 36), bronchopneumonia (n = 14), secondary pneumonia (n = 3), aspiration pneumonia (n = 5), acute exacerbation of chronic bronchitis (n = 21), and of bronchiectasis (n = 9) and acute purulent bronchitis (n = 11). General condition was good in 29 patients and poor in 58; 12 patients were critically ill. The following pathogens were isolated at baseline (source: bronchial secretions, sputum or blood): S. pneumoniae (n = 47), Haemophilus spp. (n = 17), M. catarrhalis (n = 6), Streptococcus spp. (n = 9), Staphylococcus spp. (n = 5), Klebsiella spp. (n = 4), Pseudomonas spp. (n = 1), A. calcoaceticus (n = 1) and anaerobic organisms (n = 7). Fifty-nine patients were evaluable for bacteriological response and 82 for clinical response. Bacteriological outcome was satisfactory in 29/30 patients having LRTI with parenchymal involvement (97%) and in 29/29 patients without parenchymal involvement (100%). Clinical cure was achieved in 41/43 evaluable patients with parenchymal involvement (95%) and in 37/39 patients without parenchymal involvement (95%) in the per-protocol analysis and in 54/58 patients (93%) and 37/41 patients (93%), respectively, in the clinical intention-to-treat analysis. Three of the patients with an unsatisfactory clinical response died of infection during the study. Cefodizime was well tolerated. Adverse reactions--all of mild intensity--were tachycardia, lumbalgia and dizziness, each occurring in one patient. Cefodizime 2 g once daily either i.m. or i.v. was effective in the treatment of lower respiratory tract infections in hospitalized patients.

Adult↗
PubMed1991

Cefpodoxime proxetil in upper respiratory tract infections.

Cefpodoxime proxetil is a new third generation oral cephalosporin, which shows potent antibacterial activity against both Gram-positive and Gram-negative bacteria, and high stability in the presence of beta-lactamases. Low concentrations of cefpodoxime inhibit most respiratory pathogens, including Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella (Branhamella) catarrhalis. Cefpodoxime reaches concentrations of 0.24 +/- 0.06 mg/kg in tonsils, 0.89 +/- 0.80 mg/kg in lung parenchyma, and 0.91 +/- 0.01 mg/kg in bronchial mucosa; these values exceed by far the minimum inhibitory concentrations (MICs) of cefpodoxime for respiratory pathogens. Preliminary clinical studies were carried out in 181 patients with upper respiratory tract infections: the results indicated an overall clinical response in 88.4% of patients; in 30% the clinical efficacy was excellent and in 58.5% it was good. Further studies showed clinical cure in 90.3% of patients with pharyngotonsillitis, and clinical efficacy (cure plus improvement) in 95% of those with acute sinusitis. Moreover, bacterial eradication was obtained in 78 to 96.7% of cases, most of which involved H. influenzae, streptococci, or M. catarrhalis. Cefpodoxime appears to be an effective new antibacterial that can be recommended as a drug of first choice in the treatment of most upper respiratory tract infections.

Ceftizoxime↗
PubMed2003

Pharmacokinetic aspects of levofloxacin 500 mg once daily during sequential intravenous/oral therapy in patients with lower respiratory tract infections.

Levofloxacin is considered an effective antibiotic in the treatment of community-acquired lower respiratory tract infections (LRTIs). A study was carried out on 17 in-patients to assess the pharmacokinetics of a 500 mg once-daily switch intravenous (i.v.)/oral regimen of levofloxacin in the treatment of LRTI patients. Blood samples were collected under steady-state conditions at appropriate intervals. Levofloxacin plasma concentrations were analysed by means of HPLC and pharmacokinetic parameters were estimated using the WinNonlin pharmacokinetic software package. A lower clearance of levofloxacin (<2 mL/min/kg), conditioning both a longer elimination half-life (approximately 9 h) and a larger AUC(0-tau) (approximately 80 mg/L x h), was observed for both routes in our patients than in healthy volunteers. These differences may be explained considering that levofloxacin is excreted mainly as unchanged drug by the renal route, and most of our patients (71%) were very elderly subjects whose renal function physiologically declines with age. The almost complete (> or =99%) absolute oral bioavailability suggests that a comparable exposure to the iv regimen may be achieved after oral administration. The overall clinical success rate was 94.1%.

Administration, Oral↗
PubMed1991

Efficacy of temafloxacin versus ciprofloxacin or amoxicillin for lower respiratory tract infections in smokers and the elderly.

The purpose of this study was to determine the effects of smoking history and age on the efficacy and safety of temafloxacin versus ciprofloxacin or amoxicillin in patients with lower respiratory tract infections (LRTIs). Data were pooled from six clinical trials designed to evaluate the efficacy and safety of temafloxacin in bacterial infections of the lower respiratory tract. Patients were selected for this analysis based on smoking history (n = 256) and age (greater than or equal to 65 years of age [n = 328]). Results in the smoker and elderly subgroups were compared between treatment groups and with those in nonsmoker and nonelderly subgroups. Temafloxacin 300 mg or 600 mg b.i.d., ciprofloxacin 500 mg or 750 mg b.i.d., or amoxicillin 500 mg t.i.d. was administered orally for 7-14 days. Patients were assessed at enrollment, on study days 3-7, 24-72 hours post-treatment, and at 5-9 days post-treatment. Temafloxacin and the reference drugs demonstrated comparable clinical efficacy for treatment of LRTI in smokers (93.7% and 92.5%, respectively) and the elderly (94.6% and 89.3%, respectively). However, eradication of baseline pathogens in individual patients was significantly more common after temafloxacin therapy than that following treatment with the reference drugs in both smokers (99.2% versus 91.2%, p = 0.006) and elderly patients (97.5% versus 91.5%, p = 0.028). Overall, eradication rates for pretreatment pathogens were also significantly higher in smokers (99.3% versus 91.8%, p = 0.006) and in the elderly (97.8% versus 92.3%, p = 0.027). Neither age nor smoking status had a consistent effect on the rate of premature discontinuation of study drugs. Adverse events occurred at a similar rate between treatment groups in the elderly and in the smokers. Temafloxacin appears to be a promising alternative to therapy with either ciprofloxacin or amoxicillin in the treatment of respiratory infections in high-risk patients, smokers, and the elderly.

Age Factors↗
PubMed2003

The knowledge and expectations of parents about the role of antibiotic treatment in upper respiratory tract infection--a survey among parents attending the primary physician with their sick child.

BACKGROUND: Upper respiratory tract infections (URTI) are common. The etiologic factor is usually viral, but many physicians prescribe antibiotics. We aimed to evaluate parents' expectations of and knowledge about the role of antibiotics in childhood URTI. METHODS: The study was conducted in thirteen primary care pediatric clinics. Parents of children aged 3 months to 6 years who attended with URTI symptoms were included when it was the first attendance in the current illness. Questionnaire about the current illness, reasons for attending and expectations from the visit, knowledge about URTI was filled before the visit. RESULTS: In 122 visits the average age was 2.8 +/- 1.9 years. The main reasons for the visit were to avoid complications (81%) and to be examined (78%). Expected treatment was: cough suppressants (64%), anti-congestants (57%), paracetamol (56%), natural remedies (53%) and antibiotics (25%). In 28% the child had received antibiotics in past URTI. Only 37% thought that antibiotics would not help in URTI and 27% knew that URTI is a self-limited disease. 61% knew that URTI is a viral disease. Younger parental age and higher education were associated with lower expectations to receive antibiotics (p = 0.01, p < 0.005 respectively). While previous antibiotic treatment (p < 0.001), past perceived complications (p = 0.05) and the thought that antibiotics help in URTI (p < 0.001) were associated with a greater expectation for antibiotics. CONCLUSIONS: A quarter of the parents attending the physician with URTI are expecting to get antibiotics. Predictors were lower education, older parental age, receiving antibiotics in the past and the belief that antibiotics help in URTI.

Age Factors↗
PubMed1998

Adult acute upper respiratory tract infections in Sicily: pattern of antibiotic drug prescription in primary care.

We performed an observational study of the antibiotic-prescribing behaviour of Sicilian general practitioners (GPs) in managing acute upper respiratory tract infections (URTIs). Seventy-six GPs from 25 towns, representing a patient population of 96,630, participated in the study between September 1995 and May 1996. These physicians issued 2038 antibiotic treatment courses for acute upper respiratory tract infections: 792 for acute pharyngitis, 531 for acute tonsillitis, 304 for acute laryngitis and tracheitis, 268 for suppurative and non-suppurative acute otitis media, 124 for acute sinusitis and 19 for acute rhinitis. Forty-nine different antibiotics were prescribed. The most commonly used therapeutic groups were macrolides (38.6%), cephalosporins (27.1%), a combination of penicillins with beta-lactamase inhibitors (15.7%) and extended spectrum penicillins (13.5%). For each of the above diseases, except rhinitis, more than 30 different antibiotics were used. The choice of the route of administration appeared to be influenced by the age of the patients and, significantly, by a subjective clinical assessment of disease severity rather than by any consideration of epidemiological information or evidence from clinical trials. The rather marked variation in antibiotic-prescribing pattern for URTIs among Sicilian GPs reflects lack of availability or knowledge of any local or national guidelines.

Adolescent↗
PubMed2004

Improvements in nutritional management as a determinant of reduced mortality from community-acquired lower respiratory tract infection in hospitalized children from rural central Africa.

BACKGROUND: In-hospital mortality from lower respiratory tract infections (LTRI) is unacceptably high in developing countries where LTRI are still a leading cause of death. OBJECTIVE: To identify new approaches to reduce in-hospital mortality of LRTI through the improvement of its management. METHODS: The prospectively collected database of children admitted during an 11-year period with LRTI in a pediatric rural hospital in Central Africa was reviewed to determine the predictors of death and to evaluate the impact on mortality of 4 different protocols for the management of malnutrition. RESULTS: During the study period, 859 children were admitted with a nonmeasles severe LRTI. In the 3-year period during which blood cultures were obtained, 29.0% of the children with LRTI were bacteremic, and multiresistant Enterobacteriaceae were recovered in 81.4% of positive blood cultures. Independent predictors of death in children without edema were age <24 months, dehydration and hepatomegaly with adjusted odds ratios (numbers in parentheses, 95% confidence interval) of 3.47 (1.70-7.08), 4.24 (2.11-8.50) and 2.90 (1.43-5.85), respectively. In those with edema, a significantly increased risk of death was noted for girls [4.31 (1.71-10.90)], in children with z-score of weight to height < or = -3 [5.45 (1.67-17.79)] and when the serum albumin was <16 g/l [2.58 (1.01-6.58)]. The improvement in the management of malnutrition was followed by a reduction of LRTI-related mortality in children with edema from 32.4 to 8.9% (P < 0.001). In children without edema, the LRTI-related mortality decreased from approximately 12% to 3.5% when their diet was supplemented with micronutrients. CONCLUSION: This study indicates that the improvement of the management of underlying nutritional deficiencies is crucial for the reduction of the high in-hospital case fatality rate associated with severe nonmeasles LRTI. The empiric antibiotic regimen should be modified to cover for multiresistant Enterobacteriaceae.

Age Factors↗
PubMed2000

Comparative in vivo activity of gemifloxacin in a rat model of respiratory tract infection.

The in vivo efficacy of the novel quinolone gemifloxacin (SB-265805) was examined in a rat respiratory tract infection (RTI) model against four strains of Streptococcus pneumoniae and two strains of Haemophilus influenzae with varying susceptibilities to standard antimicrobial agents. Animals were infected intrabronchially to produce pneumonia and therapy with oral gemifloxacin, amoxycillin-clavulanate, ciprofloxacin, cefuroxime, azithromycin, trovafloxacin, grepafloxacin or levofloxacin was started 24 h after infection. The doses administered were chosen to approximate in the rat the serum or tissue concentrations measured in humans following therapeutic dosing. Therapy continued once- or twice-daily for 3 days, and approximately 17 h after the end of therapy the lungs were excised for bacterial enumeration. Following infection with strains of S. pneumoniae, gemifloxacin produced a 3-5 log reduction in bacterial numbers compared with untreated animals. Gemifloxacin was as effective as amoxycillin- clavulanate, and was as potent or more potent than all other comparators. Notably, the quinolone agents trovafloxacin, ciprofloxacin, grepafloxacin and levofloxacin were significantly less effective (P < 0.01) than gemifloxacin: these agents reduced bacterial numbers by < or =3 log compared with untreated animals. Gemifloxacin produced a marked response against H. influenzae infection, reducing bacterial numbers significantly (P < 0.01) compared with untreated controls. Gemifloxacin was significantly more potent than cefuroxime and azithromycin. None of the other comparator agents was more potent than gemifloxacin. The excellent efficacy seen in these experimental models of RTI with S. pneumoniae and H. influenzae confirms the in vitro activity of gemifloxacin against these organisms. This indicates that gemifloxacin may be of significant benefit in the treatment of RTI.

Animals↗
PubMed1997

[Disturbances of polymorphonuclear neutrophil leukocyte chemiluminescence in patients with chronic or recurrent respiratory tract infections].

The disturbances of polymorphonuclear neutrophil leucocytes (PMNLs) may be considered as a one of the causes of chronic or recurrent respiratory tract infections (RTI). The study carried out on patients with chronic or recurrent RTI was aimed at attempting to assess the dependence of clinical manifestations of RTI on nonspecific PMNLs dependent cellular response status. We used the chemiluminescence (CL) assay to study the ability of PMNLs to generate free oxygen forms during phagocytosis process. CL response of PMNLs to chemotactic peptide FMLP in 48 chronic and/or recurrent RTI patients and in 50 healthy blood donors of similar age (control group) was evaluated. RTI do not seem to be dependent on decreased PMNLs count (mild neutropenia was found in 35% of patients), but they may result from impaired function of PMNLs. All the values of CL response in RTI patients were lower than the lowest value observed in control group and ranged from 2.9 to 27.6 x 10(3) cpm/10(3) PMNLs. The lowest of PMNLs CL test value were found in patients with infections of pulmonary tissue (recurrent pneumoniae). The patients with infections of higher parts of respiratory tract (nasal cavity, sinuses, pharynx, trachea and bronchi) did not present such levels of PMNLs function impairment.

Adolescent↗