PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “RESPIRATORY TRACT INFECTIONS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1996

Serologic response to measles-mumps-rubella vaccine among children with upper respiratory tract infection.

The influence of concurrent upper respiratory tract infection (URTI) on immune response to MMR (measles, mumps, rubella) vaccine was evaluated by measuring IgG levels for each viral component immediately before vaccination and 6 months after vaccination in 198 12-month-old children (101 children without URTI and 97 with URTI at time of vaccination). None of the children had antibodies to measles, mumps or rubella before vaccination. Seroconversion rates and the geometric means of the antibody titers in children without URTI and in children with URTI at the time of vaccination were similar. MMR vaccination should not be delayed in children with such infections.

Antibodies, Viral↗
PubMed2003

Treatment of adults with community-acquired respiratory tract infections: results of a multicentric clinical trial with gatifloxacin.

Respiratory tract infections have an important clinical and economic impact and they are the most common indication for antibiotic use in outpatient practice. This prospective, multicenter non-controlled trial assessed the efficacy and safety of gatifloxacin in the treatment of community-acquired respiratory tract infections. Patients were treated with a daily oral dose of gatifloxacin 400 mg for 7-14 days. The diagnosis of respiratory infection was made based on the clinical condition and/or radiologic findings. A total of 5,044 adult patients with community-acquired respiratory infections was treated with gatifloxacin in different centers in Brazil between March 1, 2001, and October 31, 2001. Among the 5,044 patients treated, 1,501 patients (29.76%) had community-acquired pneumonia, 756 (14.99%) had acute exacerbation of chronic bronchitis and 2,787 (55.25%) had acute sinusitis. Of the total of patients treated, 3,607 (71.51%) were considered cured, 1,261 (25%) progressed with some clinical improvement, 28 (0.56%) presented a relapse, 56 (1.11%) failed to treatment and 92 (1.82%) were unable to be evaluated. Adverse events were described in 634 (12.57%) patients. The most common adverse events were: nausea (2.24%); dyspepsia (1.86%); diarrhea (0.79%); change in taste (0.46%); insomnia and irritability (0.22%); dizziness (0.77%); headache (0.42%); allergic reaction (0.18%); Central Nervous System alterations insomnia, agitation, anxiety (0.46%). This study showed that the treatment of respiratory tract infections with gatifloxacin was safe and efficient and had a low incidence of adverse events.

Adult↗
PubMed2007

Efficacy of azithromycin administration in prevention of respiratory tract infection after bronchoscopic biopsy: a randomized, controlled trial.

BACKGROUND AND OBJECTIVE: Respiratory tract infection is a serious complication associated with bronchoscopic biopsy. This study attempted to examine its incidence and determine an efficacious therapy for preventing such infections. METHODS: Nine hundred and thirty patients who underwent bronchoscopic biopsy in Osaka City University Hospital outpatient clinic were enrolled in the study. All patients were randomly assigned to receive a 3-day course of azithromycin (500 mg/day), cefcapene pivoxil hydrochloride (300 mg/day) or no antibiotics. The primary outcome was the incidence of respiratory tract infection after bronchoscopic biopsy among the three groups. RESULTS: In the no-treatment group, nine of the 310 patients (2.9%) had respiratory tract infection after bronchoscopic biopsy. All patients with infection had abnormal bronchoscopic findings. Of the patients with respiratory tract infection, 60% were in the no-treatment group, 26.7% in the cefcapene group and 13.3% in the azithromycin group. Although not statistically significant, the incidence in the azithromycin group (0.7%) was lower than in the no-treatment group (P = 0.06). Among the patients with abnormal bronchoscopic findings, the incidence in the azithromycin group was significantly lower than that in the no-treatment group (3.0% vs. 14.8%; P = 0.02). Moreover, maximum C-reactive protein values also appeared to be lower in the azithromycin group than in the no-treatment group and the cefcapene group. CONCLUSIONS: A 3-day course of azithromycin administration is well tolerated and effective in preventing infection post bronchoscopy.

Adult↗
PubMed2001

Airflow limitation during respiratory syncytial virus lower respiratory tract infection predicts recurrent wheezing.

BACKGROUND: Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is frequently followed by recurrent wheezing. Thus far no clinical risk factors have been identified to predict which infants will have wheezing episodes subsequent to RSV LRTI. OBJECTIVE: To determine clinical predictors for airway morbidity after RSV LRTI. METHODS: In a 1-year follow-up study we investigated the predictive value of auscultatory findings characteristic of airflow limitation (wheezing) during RSV LRTI for subsequent airway morbidity. Clinical characteristics, including the presence or absence of signs of airflow limitation, of hospitalized infants with RSV LRTI were prospectively recorded during 2 winter epidemics. During a 1-year follow-up period parents of 130 infants recorded daily airway symptoms. OUTCOME MEASURE: Recurrent wheezing defined as > or = 2 episodes of wheezing. RESULTS: Signs of airflow limitation during RSV LRTI were absent in 47 (36%) infants and present in 83 (64%) infants. Recurrent wheezing was recorded in 10 (21%) infants without signs of airflow limitation and in 51 (61%) with signs of airflow limitation during initial RSV LRTI (relative risk, 0.29, P < 0.001). In a multiple logistic regression model, airflow limitation during initial RSV LRTI proved independent from other clinical parameters, including age, parental history of asthma and smoke exposure. CONCLUSIONS: A sign of airflow limitation during RSV LRTI is the first useful clinical predictor for subsequent recurrent wheezing.

Auscultation↗
PubMed1995

Antimicrobial agents for community-acquired respiratory tract infections.

Chemotherapy of community-acquired respiratory tract infections was reviewed from a microbiological perspective. The current worldwide spread of penicillin-resistant Streptococcus pneumoniae and of ampicillin-resistant Haemophilus influenzae has required a reassessment of the antimicrobial agents being used for empiric therapy. In vitro data with different orally administered antibiotics were reviewed in order to identify any deficiencies in their spectra of activity against four common respiratory tract pathogens. Cefixime, cefuroxime axetil, cefprozil, amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole were active against all four species other than penicillin-resistant pneumococci.

Ampicillin Resistance↗
PubMedDate not supplied

Lower respiratory tract infections in the pediatric patient.

Lower respiratory tract infections in children are common and vary from relatively self-limited courses to life-threatening presentations. Recognition of disease patterns as they relate to age, sex, race, season, geography, environmental, and socioeconomic conditions is crucial in determining appropriate differential diagnosis and treatment strategies. The majority of children with respiratory infections will present to the primary care provider in an office setting and less frequently may require immediate referral from home or the outpatient setting to an emergency department. For children with recurrent or chronic respiratory infections, referral to a subspecialist may also be necessary. Primary providers are key in determining the extent of diagnostic effort, interventions, referrals, repeat evaluations, and in reinforcing treatment plans with children and their families.

Adolescent↗
PubMed1989

Assessment of clinical criteria for identification of severe acute lower respiratory tract infections in children.

222 acute lower respiratory tract infections (LRI), as defined by the World Health Organisation, were identified during one year's surveillance of a cohort of 500 Gambian children aged 0 to 4 years. Symptoms and signs at presentation were related to radiological evidence of lobar consolidation, indicating severe LRI. In infants, a fever of greater than 38.5 degrees C, refusal to breast-feed, or the presence of vomiting were the best predictors of severe LRI. In children aged 1 to 4 years, a fever of greater than 38.5 degrees C or a respiratory rate greater than 60/min were the most accurate clinical signs for severe LRI. Chest indrawing did not discriminate severe LRI. These community-based findings differ from results of hospital-based studies.

Acute Disease↗
PubMed1976

The incidence and aetiology of respiratory tract infections in general practice--with emphasis on Mycoplasma pneumoniae.

The incidence of respiratory tract infections in patients seeking medical advice at a community care centre (Dalby) during 1973 and 1974 was studied. About every third patient seen at this primary health station presented with signs of such infections. In the age groups less than 10, 10-19, 20-39, 40-59 and greater than or equal to 60 years, respiratory tract infections accounted for 65, 45, 32, 18 and 9% of the fotal number of diagnoses made during 1974. The aetiology of acute respiratory tract infections in a series of patients seen at this health station was studied. The series included randomly selected cases, but excluded children under seven years of age and patients presenting with signs of acute otitis media and tonsillitis. Attempts to establish the aetiology were made on the basis of the history, the clinical examination, and cultures for beta-haemolytic streptococci and Mycoplasma pneumoniae, complement foxation tests for influenza A and B, para-influenza 1, 2, and 3, adeno, cytomegalovirus and respiratory syncytial virus, and Chlamydia psittaci. Paul-Bunnell test and tests for cold agglutinins were also performed. With this test battery, an aetiological diagnosis was obtained in only 33% of the 101 patients studied. The findings suggest an infection with M.pneumoniae in 16%, with beta-haemolytic streptococci in 9%, and with viruses (adeno and para-influenza) in 7% of the patients. The present communication highlights the role of M.pneumoniae in upper respiratory infections, as few data have appeared on such infections in patients seen in general practice. The difficulty of establishing the aetiology of respiratory tract infections and the consequent treatment dilemma is discussed.

Adolescent↗
PubMed2003

Human metapneumovirus-associated lower respiratory tract infections among hospitalized human immunodeficiency virus type 1 (HIV-1)-infected and HIV-1-uninfected African infants.

Respiratory tract infections due to human metapneumovirus (hMPV) have been reported worldwide, with the exception of Africa. The prevalence of hMPV infection was studied among human immunodeficiency virus type 1 (HIV-1)-infected and HIV-1-uninfected African infants who were hospitalized for lower respiratory tract infections (LRTIs). Nasopharyngeal aspirate samples obtained from 81 HIV-1-infected and 110 HIV-1-uninfected infants who had tested negative for other respiratory viruses were selected for investigation. hMPV was detected in 10 HIV-1-uninfected infants (9.1%) and 3 HIV-1-infected infants (3.7%). Compared with the entire cohort of HIV-1-uninfected infants, hMPV was 4.6-fold less common than respiratory syncytial virus, but it was 3.2-fold more common than influenza virus and 2.1-fold more common than parainfluenza virus types 1-3. Genotyping of 7 of 14 isolates revealed the circulation of 2 major phylogenetic groups of the virus, which were similar to those described in North America and Europe.

Africa↗
PubMedDate not supplied

The descriptive epidemiology of severe lower respiratory tract infections in children in Kiel, Germany.

BACKGROUND: Lower respiratory tract infections (LRI) inflict a high burden of disease in children worldwide. Longitudinal, descriptive epidemiological data on different forms of LRI are urgently needed to differentiate this burden, compare population-based incidence rates between countries and to recognize trends. PATIENTS AND METHODS: From July 1996 to June 2000, all children hospitalized with LRI, i. e. laryngo-tracheo-bronchitis (LTB), bronchitis, wheezing bronchitis-bronchiolitis (WBB), bronchopneumonia and pneumonia, in the municipal area of Kiel, Schleswig-Holstein, Germany, were analyzed by cross-sectional studies. Naso-pharyngeal aspirates (NPA) were analyzed by an in-house 9-valent multiplex-RT-PCR. RESULTS: In the 4-year observational period, 1 072 children aged 0 to 16 years (median 23 months) were hospitalized with LRI: 12 % (median 28 months) with LTB, 11 % (median 17 months) with bronchitis, 28 % (median 13 months) with WBB, 26 % (median 26 months) with bronchopneumonia and 22 % (median 47 months) with pneumonia. The prevalence of chronic underlying conditions (20 %) and low gestational age (13 %) varied in the different forms of LRI. The cumulative incidence rate of LRI rose steadily over the 4 years. The highest fraction was contributed by WBB, while pneumonia declined. The highest incidence rate ratio was attributable to respiratory syncytial virus (RSV, 0.46) and to children under 2 years of age. CONCLUSIONS: LRI, especially obstructive forms of LRI, are increasing in Germany as described earlier for the USA, UK and Sweden. The major burden is carried by children under 2 years. RSV is the single pathogen with the highest impact.

Adolescent↗
PubMedDate not supplied

[The epidemiology of nasopharyngeal colonisation of Streptococcus pneumoniae in children with respiratory tract infection].

Nasopharyngeal swab specimens from 324 children with respiratory tract infections were evaluated to detect the rate of Streptococcus pneumoniae colonisation. S. pneumoniae was detected in 92 (28%) of the subjects. Forty three (46.7%) of the isolates were serotyped by the capsular swelling tests. The most common serotypes were 19F, 6B, 3 and 23F. The 7, 9 and 11 valent conjugate pneumococcal vaccines covered 35.8%, 40% and 46.7% of all the S. pneumoniae isolates, respectively. Thirty two (34.8%) isolates exhibited penicillin MIC values between 0.1 and 1 microg/ml, only 1 isolate had MIC > or = 2 microg/ml. Penicillin resistant pneumococcal colonisation was most frequently detected in children with viral upper respiratory tract infections (12.5%). Resistance rates of trimetoprim-sulfamethoxazole, erythromycin, chloramphenicol, clindamycin, ceftriaxone, rifampin were 31.5%, 9.8%, 6.5%, 4.3%, 1%, 0%, respectively. Being a children of a family with low income was the only risk factor for colonisation with S. pneumoniae, whereas having a sibling attending to a day care center, antibiotic use in the last three months and use of more than one antibiotic were significant risk factors for colonisation with penicillin resistant S. pneumoniae (p < 0.05).

Adolescent↗
PubMed2001

Barriers to the effective management of respiratory tract infections in the community.

The treatment of respiratory tract infections (RTIs) continues to challenge the knowledgeable and conscientious physician. Upper RTIs such as sinusitis and tonsillitis/pharyngitis - while not generally life-threatening - are associated with personal cost and suffering, while infections of the lower respiratory tract, including community-acquired pneumonia (CAP) and acute exacerbations of chronic bronchitis (AECB), represent a more serious clinical challenge and account for almost half of all community-acquired infections. Moreover, such infections may be fatal. Laboratory tests for etiologic agents of RTIs are often insensitive and slow and identify the causative pathogen in only a minority of cases. Therapy for RTIs is, therefore, generally presumptive and instituted before there is a clear understanding of etiology. Such an approach requires antibacterials that possess a spectrum of activity which covers both the common and atypical/intracellular pathogens associated with RTIs to enable physicians to confidently prescribe treatment. A major barrier to the confident prescribing of empiric therapies for RTIs is the increasing prevalence of resistance to existing antibacterial agents among respiratory tract pathogens. Increasing levels of antibacterial resistance now threaten the utility of existing agents, primarily the beta-lactams and macrolides, and continue to drive the search for newer agents which retain activity against drug-resistant respiratory tract pathogens. This need is emphasized by recent evidence that bacterial resistance may be associated with poorer clinical outcomes, particularly for patients with severe infections. There is enormous concern and uncertainty about the factors that contribute to increasing bacterial resistance and treatment strategies that should be adopted to minimize this problem. The arguments have raged particularly around recent Infectious Diseases Society of America (IDSA) guidelines on the treatment of CAP, which have advocated a greater role for fluoroquinolones. One school of thought - driven in part by concerns over cost of therapy - advocates the use of older agents such as amoxicillin, in the hope that any resistance that is incurred will be to these agents, leaving the newer agents for select cases with acquired resistance. Advocates of the newer agents argue that this approach represents a false economy and that there is a greater likelihood of first-line success with newer agents, so that patients are less likely to require a second physician visit and a second course of antibacterial therapy.

Anti-Bacterial Agents↗
PubMedDate not supplied

Antibiotic treatment and survival of nursing home patients with lower respiratory tract infection: a cross-national analysis.

PURPOSE: Although lower respiratory tract infections are a leading cause of death in frail elderly patients, few studies have compared treatments and outcomes. We assessed the effects of different antibiotic treatment strategies on survival of elderly nursing home residents with lower respiratory tract infections in the United States and the Netherlands, where treatment approaches are quite different. METHODS: We combined data from 2 prospective cohort studies of lower respiratory tract infections conducted in 36 nursing homes in the United States and 61 in the Netherlands. We included residents whose infections were treated with antibiotics: 806 in the United States and 415 in the Netherlands. Outcome measures were 1-month and 3-month mortality. We used logistic regression to adjust for differing illness severity. RESULTS: Dutch residents had higher mortality than US residents (28.1% vs 15.1% at 1 month, respectively; P <.001). After adjusting for illness severity with logistic regression, the differences between the Dutch and US populations were not significant (odds ratio 1.34; 95% confidence interval, 0.94-1.90). Predicted mortality was overestimated for more severely ill US residents at 1 month but not at 3 months. No antibiotic regimen was consistently associated with increased or decreased mortality. CONCLUSION: Despite differences in illness severity and treatment, adjusted mortality did not differ between the 2 countries. Although we cannot exclude a short-term survival benefit from more aggressive treatment in the United States, differences in baseline health appear prognostically more important than the type of antibiotic treatment.

Aged↗
PubMed2006

Role of ribomunyl((r)) in the prevention of recurrent respiratory tract infections in adults : overview of clinical results.

Recurrent respiratory tract infections (RRTIs) in adults are the result of an imbalance between lung defense mechanisms, and bacterial burden. Antibacterial treatments can temporarily restore the equilibrium between host and bacterial load, but do not prevent recurrence of infection. An alternative approach to prevent recurrence of infection is treatment with an immunostimulant, which provides immune protection against repeated bacterial and viral infection. All immunostimulant products are bacterial in origin: lysates (first generation immunostimulants), or bacterial extracts, like bacterial ribosomes, or membrane proteoglycans. This review highlights the current state of knowledge regarding the use of immunostimulants in adults with RRTIs, taking the ribosomal immunostimulant Ribomunyl((R)) as an example. Many studies are available on the mechanism of action and clinical efficacy in prevention of RRTIs in adults treated with Ribomunyl((R)). The effect of this immunostimulant on anti-infectious responses is explained by a stimulation of both nonspecific (innate) and specific (adaptive) immunity. In order to obtain a global overview of the therapeutic efficacy of Ribomunyl((R)) the most pertinent trials were selected from the literature based on adequate patient numbers and good methodology. Results of double-blind placebo-controlled trials using Ribomunyl((R)) for the treatment of different upper or lower RRTIs have demonstrated a statistically significant reduction in the number of infectious episodes and as a consequence, a decrease in antibacterial consumption, after 3 and 6 months of treatment. The tolerance profile of Ribomunyl((R)) was good in all studies. Economic evaluations suggest that savings can be made in healthcare expenditure, in patients with recurrent episodes of infection. It is concluded that Ribomunyl((R)) is effective in preventing and reducing upper and lower respiratory tract infections in adults. The product may also have an impact on reducing the development of bacterial resistance, as a result of fewer courses of antibacterials required to treat patients with RRTIs.

Adjuvants, Immunologic↗
PubMed1998

Criteria used by clinicians to differentiate sinusitis from viral upper respiratory tract infection.

BACKGROUND: Acute sinusitis and upper respiratory tract infections (URIs) share many common symptoms and signs. Objective criteria have been identified that are valid for distinguishing between these two clinical problems. The objective of this study was to determine how often clinicians use these validated criteria and how often they rely on clinical cues that are less valuable for differentiating sinusitis from URI. METHODS: We performed a retrospective review of 734 patients with a diagnosis of acute sinusitis (n = 367) or URI (n = 367) at a family practice residency training site over a 3-year period. Charts were reviewed to ascertain patient demographics, past history, current symptoms, physical findings, and treatment prescribed. RESULTS: Patients with sinusitis were likely to be older, female, smokers, have a history of allergic rhinitis, and have longer symptom durations. Complaints of sinus pressure or discolored nasal discharge and the finding of sinus tenderness were strongly associated with the diagnosis of sinusitis. In multivariate analysis, eight factors were independently associated with the diagnosis of sinusitis. Four clinical cues alone (sinus tenderness, sinus pressure, postnasal drainage, and discolored nasal discharge) were highly associated with the diagnosis of sinusitis and explained 60% of the variation in the diagnosis between sinusitis and URI. CONCLUSIONS: Physicians tend to rely on four factors to differentiate sinusitis from URIs. Only one of these has been shown to be a reliable predictor of acute sinusitis. This use of unreliable criteria may lead to misdiagnoses and inappropriate prescriptions for antibiotics.

Acute Disease↗
PubMed1994

Seroconversion rates to combined measles-mumps-rubella-varicella vaccine of children with upper respiratory tract infection.

OBJECTIVE: To determine if upper respiratory tract infection (URI) affects the seroconversion rate or quantitative response to each component of a combined measles-mumps-rubella-varicella vaccine. SUBJECTS AND METHODS: One hundred forty-nine children between 15 and 18 months of age were prospectively divided into two groups according to the presence of URI or recent history of URI symptoms within the 4 weeks before vaccination. Once stratified, 74 children in the healthy group and 75 children in the URI group were randomly assigned to receive one of three lots of measles-mumps-rubella varicella vaccine by subcutaneous injection into the deltoid area. Serum was obtained from each child just before vaccination and 4 to 6 weeks later for measuring antibody levels against each virus. RESULTS: Prevaccination antibody levels against each virus in the URI and healthy groups did not differ. Nine children had pre-existing antibodies to varicella and six to mumps; no child had positive serologies for measles or rubella before vaccination. Children with pre-existing antibody were excluded from analysis of seroconversion for that virus. Seroconversion to measles, mumps, and rubella occurred in 100% of children in both groups. Mean antibody levels did not differ between the healthy and URI groups for measles (111 vs 122), mumps (97 vs 108), or rubella (96 vs 102). Three (4%) of 70 children with URIs in whom varicella serologies were available failed to seroconvert to varicella vaccine although none of the 69 healthy children had vaccine failure (P = .24). The mean varicella antibody level was 11.3 +/- 1.4 in the healthy children, which did not differ significantly from the level of 9.5 +/- 0.9 in the URI group. CONCLUSIONS: Seroconversion to measles, mumps, rubella, and varicella was not significantly affected by the presence of a concurrent or recent URI in 15- to 18-month-old children.

Antibodies, Viral↗
PubMed2004

[Bronchoscopic specimen collection, role of the protected specimen brush in lower respiratory tract infections].

INTRODUCTION: The ineffectiveness of microbiological methods in the lower respiratory tract infections are caused by anachronistic sampling methods. Authors checked the protected specimen brush effectiveness and those of the influencing factors. MATERIALS AND METHODS: 103 patients were involved in the study. The causative agents were identified in 44 cases. These results were compared to last year's classic sampling techniques and they experienced 20.4% improvement of the sensitivity. Further increasing in effectiveness can be reached if we perform bacteriological sampling after the first unsuccessful antibiotic treatment was performed. Out of 103 examined patients only 69 underwent antibiotic treatment. In the case of 13 patients after the course of one type antibiotic treatment 10 positive bacteriological cultures were positive. In the case of 31 patients 2 types of antibiotics were administered sequentially and examined afterwards and the authors found 15 positive bacteriological cultures. In the case of 25 patients the administered sequentially 3 times of antibiotics and examined afterwards, 6 cultures were positive. CONCLUSION: The examinations prove that the protected specimen brush, used in time, raises the sensitivity of microbiological processes.

Adult↗