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PubMed1984

[Clinical use of cefoxitin in respiratory tract infections].

Cefoxitin (CFX) was used in 9 patients who had respiratory tract infections and following results were obtained: CFX was used in 2 patients with acute pneumonia, 2 with lung abscess, 3 with a mixed infection of lung cancer, 1 with a mixed infection of pulmonary tuberculosis and 1 with empyema. The overall efficacy rate was 77.8%; results were excellent in 2, good in 5 and poor in 2. Bacteriologically, all strains except P. aeruginosa were eradicated after treatment. No side effects were observed. A slight transient elevation of transaminase was observed in 1 patient after doses of 4 approximately 8 g daily. From the above, CFX seems to be a useful and safe drug as an initial choice in the treatment of respiratory tract infections.

Adult↗

PubMed2001

Evaluation of concurrent shedding of bovine coronavirus via the respiratory tract and enteric route in feedlot cattle.

OBJECTIVE: To assess the relationship between shedding of bovine coronavirus (BCV) via the respiratory tract and enteric routes and the association with weight gain in feedlot cattle. ANIMALS: 56 crossbred steers. PROCEDURES: Paired fecal samples and nasal swab specimens were obtained and were tested for BCV, using antigen-capture ELISA. Paired serum samples obtained were tested for antibodies to BCV, using antibody-detection ELISA. Information was collected on weight gain, clinical signs, and treatments for enteric and respiratory tract disease during the study period. RESULTS: Number of samples positive for bovine respiratory coronavirus (BRCV) or bovine enteric coro navirus (BECV) was 37/224 (17%) and 48/223 (22%), respectively. Some cattle (25/46, 45%) shed BECV and BRCV. There were 25/29 (86%) cattle positive for BECV that shed BRCV, but only 1/27 (4%) cattle negative to BECV shed BRCV. Twenty-seven of 48 (56%) paired nasal swab specimens and fecal samples positive for BECV were positive for BRCV. In contrast, only 10/175 (6%) paired nasal swab specimens and fecal samples negative for BECV were positive for BRCV. Only shedding of BECV was associated with significantly reduced weight gain. Seroconversion to BCV during the 21 days after arrival was detected in 95% of the cattle tested. CONCLUSIONS AND CLINICAL IMPLICATIONS: Feedlot cattle infected with BCV after transport shed BCV from the respiratory tract and in the feces. Fecal shedding of BCV was associated with significantly reduced weight gain. Developing appropriate control measures for BCV infections could help reduce the decreased weight gain observed among infected feedlot cattle.

Animals↗

PubMed1982

[Clinical trials of netilmicin against respiratory tract infection].

Netilmicin, a new semisynthetic aminoglycoside antibiotic recently developed by Shering Co., was injected to 5 patients with respiratory tract infection (2 cases of diffuse panbronchiolitis, 2 cases of bronchiectasis and 1 case of bronchial asthma with infection). A daily dose of netilmicin was 200 mg by intramuscular injection and duration of netilmicin therapy was for 7 to 14 days. Clinical response to netilmicin therapy of respiratory tract infection was good in 3 cases, fair in 1 case and poor in 1 case. No subjective and objective findings considered as the side effect was observed and laboratory examinations showed no abnormality. It may be concluded from the above clinical results that netilmicin may be effective for respiratory tract infections and further study may prove its efficacy.

Adult↗

PubMed1997

Moraxella (Branhamella) catarrhalis adherence to human bronchial and oropharyngeal cells: the role of adherence in lower respiratory tract infections.

To study the role of Moraxella (subgenus Branhamella) catarrhalis (B. catarrhalis) adherence to airway cells in lower respiratory tract infections, the in vitro attachments of B. catarrhalis to upper airway (oropharyngeal) and lower airway (bronchial) epithelial cells were compared. The adherence of 4 strains (1 nonfimbriated and 3 fimbriated) of B. catarrhalis to respiratory tract epithelial cells collected from 11 patients with chronic pulmonary disease (CPD) and 11 healthy individuals was evaluated. Both the fimbriated and nonfimbriated strains showed increased attachment to oropharyngeal cells in the CPD patients (mean +/- SEM; 25.0 +/- 3.2/cell; P < 0.01) when compared to the control subjects (12.1 +/- 1.1/cell). On the average, the attachment to bronchial cells was 6.1 to 13.6 times greater per surface area (bacteria/micron2) than the attachment to oropharyngeal cells. The fimbriated strains tended to adhere in higher numbers to bronchial cells (19.0 +/- 1.8/cell) than the nonfimbriated strain (8.7 +/- 1.2/cell), although there was no difference between the CPD and control groups. In conclusion, the attachment of B. catarrhalis to oropharyngeal cells may be an enhancing factor for colonization in the upper respiratory tract in patients with CPD, and elevated adherence of the bacteria to bronchial cells may suggest pathogenic importance when mucociliary function is impaired.

Adult↗

PubMed1999

Antibiotic prescribing by pediatricians for respiratory tract infection in children.

To examine antimicrobial prescribing rates for viral respiratory tract infections by primary care pediatricians in the greater Toronto area, charts were reviewed for the week of 17-21 February 1997 at 61 pediatricians' offices. Antibiotics were considered appropriate if the diagnosis was compatible with bacterial infection. A total of 3,585 patient visits were reviewed. The common cold was the most common respiratory tract syndrome leading to an office visit (1,317 visits). The overall rate of appropriate antibiotic prescribing was 89.5%. There was no significant difference in prescribing when physicians were compared by year of graduation from medical school, sex, or location of training. Diagnostic codes (ICD-9 [International Classification of Diseases, 9th edition] codes) did not match the chart diagnosis in 41% of cases. Toronto primary care pediatricians appear to have a lower rate of inappropriate antibiotic prescribing than do primary care physicians in other regions of Canada and the United States.

Anti-Bacterial Agents↗

PubMed1996

Comparison of tilmicosin with long-acting oxytetracycline for treatment of respiratory tract disease in calves.

OBJECTIVE: To compare the effect of a single parenteral injection of tilmicosin with that of a single dose of a long-acting oxytetracycline as treatment in the early stages of naturally acquired undifferentiated respiratory tract disease in young dairy calves. DESIGN: Prospective clinical trial, randomized block design. ANIMALS: 40 dairy calves. PROCEDURES: 78 calves from 5 farms were examined weekly until 3 months old. When respiratory tract disease was diagnosed by a veterinarian, the calf was assigned to 1 or 2 treatment groups. Transtracheal wash samples were acquired to characterize the pathogens. The veterinarian, who was unaware of treatment assignments, examined calves for 3 days after treatment and evaluated severity, using a scoring system. Growth rates were measured. RESULTS: On the basis of response to initial treatment, relapse rates, and effect on growth rates, the antibiotics were determined to be equally effective. Severity of clinical disease was significantly (P < 0.03) less for the tilmicosin-treated calves on days 2 and 3 after treatment. Findings from analysis of transtracheal wash samples indicated Pasteurella multocida (25/40), P haemolytica (4/40), Haemophilus somnus (4/40), Actinomyces pyogenes (3/40), and Aspergillus sp (2/40). Mycoplasma was isolated in association with bacterial isolates in 22 calves. CLINICAL IMPLICATIONS: Tilmicosin and oxytetracycline are effective in treatment of respiratory tract disease in young calves, even when Mycoplasma spp are involved. Tilmicosin is more effective in resolving clinical signs. Early treatment of dairy calves with respiratory tract disease may decrease detrimental effects on growth.

Animals↗

PubMed2002

Sequence stability of the gene encoding outer membrane protein P2 of nontypeable Haemophilus influenzae in the human respiratory tract.

Nontypeable Haemophilus influenzae (NTHI) is an important cause of lower respiratory tract infections in patients with chronic obstructive pulmonary disease. Recent findings suggest that the major outer membrane protein P2 should be reconsidered as a vaccine candidate for NTHI. A P2-based vaccine would require a relative degree of sequence stability of the gene encoding P2 (ompP2) during colonization. To characterize the sequence stability of ompP2 during colonization of the human respiratory tract, ompP2 genes from 13 sets of isolates that persisted in patients with chronic obstructive pulmonary disease (mean colonization, 7 months) were sequenced. In 9 sets of isolates, ompP2 did not change. Sequence changes were noted in 4 sets of isolates. Most of these changes occurred within areas of repetitive DNA, suggesting that this type of DNA has a role in antigenic variation of P2. The sequence of ompP2 is relatively stable during persistence of NTHI in the human host.

Amino Acid Sequence↗

PubMed1989

[Hemagglutinating activity of Escherichia coli isolated from the respiratory tract in comparison with those isolated from urine feces and blood].

Various bacteria with pili are able to agglutinate human and animal red blood cells. Hemagglutinating activity of 131 strains of Escherichia coli isolated from respiratory tract (24 strains), urine (64 strains), feces (36 strains) and blood (7 strains) were tested using human type A, guinea pig, bovine and chicken erythrocytes. Concerning the hemagglutination activity for erythrocytes from at least one of four species (human, guinea pig, bovine, chicken), the strains isolated from respiratory tract showed a higher level than those isolated from feces (p less than 0.01) or those isolated from blood (p less than 0.1). Agglutination of human erythrocytes: Of 131 strains, mannose-sensitive agglutination was observed in 31 strains, mannose-resistant agglutination in 40 strains and non-agglutination in 60 strains. More agglutinated strains were isolated from the respiratory tract than those isolated from blood but not with statistical significance (p less than 0.1). Agglutination of guinea pig erythrocytes: Of 131 strains, mannose-sensitive agglutination was observed in 56 strains, mannose-resistant agglutination in 10 strains and non-agglutination in 65 strains. More agglutinated strains were isolated from the respiratory tract than from urine, feces and blood (p less than 0.01), and of those, 89% were mannose-sensitive agglutination. Agglutination of bovine erythrocytes: Of the 131 strains, mannose-sensitive agglutination was observed in 4 strains, mannose-resistant agglutination in 6 strains and non-agglutination in 121 strains. Therefore, only a few agglutinated strains were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1992

Azithromycin in lower respiratory tract infections.

Azithromycin is a new azalide antimicrobial agent which has a broad spectrum of activity against common lower respiratory tract pathogens including pneumococci, staphylococci, Legionella species, Mycoplasma and Chlamydia species. In particular, it is more active against Haemophilus influenzae than other macrolides. In comparison to other new macrolides, azithromycin achieves higher tissue and intracellular concentrations and these concentrations are sustained for several days after dosing due to a long elimination half-life. The efficacy of azithromycin against lower respiratory tract infections has been proven in several clinical studies. Once-daily dosing with azithromycin, over a 3- or 5- day period was as effective as a 10-day course of other commonly used antibiotics such as amoxycillin/clavulanic acid, erythromycin or cefaclor in lower respiratory tract infections. Azithromycin short-course therapy may offer an advantage in terms of patient compliance and the duration of treatment.

Animals↗

PubMed1989

Epidemiology of gastro-intestinal and respiratory tract diseases in rural areas of Varanasi (India).

The pattern of gastro-intestinal (GIT) and Respiratory tract (RTI) diseases in rural areas of the Varanasi district, U.P. (India) was studied from the outpatient (OPD) attendance between July 1985 to June 1986. Out of a total of new patients, 19.71% had respiratory diseases in contrast to 27.9% with GIT disease. A decreasing trend was observed in attendance rates as age advanced. The difference in age distribution of males and females was statistically significant. The attendance rates for GIT diseases were higher in female (29.16%) than in males (25.16%) whereas in RTI, the rates were higher in males (19.39%) than in females (18.77%). The attendance rate was found to be higher in rainy season (23.59%) followed by summer (14.50%). Diarrhoea (15.44%) and upper (URTI) respiratory tract infection (19.93%) occupied the major recorded episodes.

Adolescent↗

PubMed1997

Effect of bombesin on impairment of upper respiratory tract immunity induced by total parenteral nutrition.

OBJECTIVE: To determine the effect of the neuropeptide bombesin on total parenteral nutrition-induced impairment of upper respiratory tract immunity. DESIGN: Randomized, controlled trial. PARTICIPANTS: Thirty-six adult male Institute for Cancer Research mice weighing 25 to 35 g. INTERVENTIONS: Mice were inoculated intranasally with H1N1 virus. At 3 weeks, mice were randomized to receive chow plus intravenous saline (n = 12), intravenous total parenteral nutrition (n = 12), or intravenous total parenteral nutrition plus bombesin (n = 12) administered 3 times daily at 15 micrograms/kg. After 5 days, mice were rechallenged with intranasal virus and killed at 40 hours to determine viral shedding from the respiratory tract; normal convalescent mice do not shed virus because of intact IgA-mediated mechanisms. MAIN OUTCOME MEASURES: Viral shedding was determined by collection of nasal secretions. Samples were diluted and incubated with a suspension of Madin-Darby canine kidney cells. Viral growth was determined by hemagglutination. RESULTS: Body weight was similar between the total parenteral nutrition and bombesin groups; however, both were significantly lower than that in the chow group (P < .05). After 6 days of feeding, no mice in the chow group shed virus, compared with 6 (50%) of the mice in the total parenteral nutrition group. Of the mice in the bombesin group, only 1 was positive for viral shedding. The total parenteral nutrition group showed increased viral shedding compared with both the chow group (P < .01) and the bombesin group (P < .05). CONCLUSIONS: Exogenous administration of bombesin reversed the total parenteral nutrition-associated impairment of upper respiratory tract immunity to an IgA-mediated infectious challenge. These observations support the concept of a common mucosal immune system, since neuropeptides are endogenous to the gastrointestinal and respiratory tracts. Hormonal modulation of immunity is a promising avenue of treatment for patients who require total parenteral nutrition.

Animals↗

PubMed2004

Caregivers' practices, knowledge and beliefs of antibiotics in paediatric upper respiratory tract infections in Trinidad and Tobago: a cross-sectional study.

BACKGROUND: Antibiotic overuse and misuse for upper respiratory tract infections in children is widespread and fuelled by public attitudes and expectations. This study assessed knowledge, beliefs, and practices regarding antibiotic use for these paediatric infections among children's caregivers' in Trinidad and Tobago in the English speaking Caribbean. METHODS: In a cross-sectional observational study, by random survey children's adult caregivers gave a telephone interview from November 1998 to January 1999. On a pilot-tested evaluation instrument, respondents provided information about their knowledge and beliefs of antibiotics, and their use of these agents to treat recent episodes (< previous 30 days) of upper respiratory tract infections in children under their care. Caregivers were scored on an antibiotic knowledge test and divided based on their score. Differences between those with high and low scores were compared using the chi-square test. RESULTS: Of the 417 caregivers, 70% were female and between 18-40 years, 77% were educated to high school and beyond and 43% lived in urban areas. Two hundred and forty nine (60%) respondents scored high (>or12) on antibiotic knowledge and 149 (34%) had used antibiotics in the preceding year. More caregivers with a high knowledge score had private health insurance (33%), (p < 0.02), high school education (57%) (p < 0.002), and had used antibiotics in the preceding year (p < 0.008) and within the last 30 days (p < 0.05). Caregivers with high scores were less likely to demand antibiotics (p < 0.05) or keep them at home (p < 0.001), but more likely to self-treat with antibiotics (p < 0.001). Caregivers administered antibiotics in 241/288 (84%) self-assessed severe episodes of infection (p < 0.001) and in 59/126 (43%) cough and cold episodes without visiting a health clinic or private physician (p < 0.05). CONCLUSIONS: In Trinidad and Tobago, caregivers scoring low on antibiotic knowledge have erroneous beliefs and use antibiotics inappropriately. Children in their care receive antibiotics for upper respiratory tract infections without visiting a health clinic or a physician. Educational interventions in the community on the consequences of inappropriate antibiotic use in children are recommended. Our findings emphasise the need to address information, training, legislation and education at all levels of the drug delivery system towards discouraging self-medication with antibiotics in children.

Adult↗

PubMed2002

Physiologically based pharmacokinetic modeling of styrene and styrene oxide respiratory-tract dosimetry in rodents and humans.

Styrene (ST) is widely used to manufacture resins, glass-reinforced plastics, and a number of commercially important polymers (Miller et al., 1994). Chronic ST inhalation studies in rodents have demonstrated unique species specificity in the resulting pulmonary toxicity and carcinogenicity. Increased incidences of pulmonary bronchioloalveolar tumors have been observed in mice, but not in rats. No other tumor type was increased significantly in either species. Clara cells lining the respiratory epithelium metabolize ST to styrene 7,8-oxide (SO), which is cytotoxic and weakly genotoxic. Rodent species show marked differences in the distribution and regional density of Clara cells within the respiratory tract, as well as in their capacity to produce and eliminate SO. A mode of action-based physiologically based pharmacokinetic (PBPK) model was developed to predict the concentration of ST and SO in blood, liver, and the respiratory-tract tissues, particularly in terminal bronchioles (target tisue), in order to conduct interspecies extrapolations and determine the extent to which there is a pharmacokinetic basis for the observed species specificity. This PBPK model has a multicompartment description of the respiratory tract and incorporates species-specific quantitative information on respiratory-tract physiology, cellular composition, and metabolic capacity. The model is validated against multiple data sets, including blood, liver, and whole lung tissue concentration of ST and SO following multiple routes of exposure. The trend in neoplastic incidences in mice correlated well with model-estimated SO concentration in the terminal bronchioles. The PBPK model predicts a 10-fold lower SO concentration in the terminal bronchioles in rats compared to mice, which is consistent with the observed species sensitivity to the development of respiratory-tract neoplasms. The model-based analysis suggests that humans would be expected to be 100-fold less sensitive to ST-inducted lung tumors than mice, based on pharmacokinetic differences. Pharmacodynamic factors are also expected to contribute to species sensitivity, potentially augmenting pharmacokinetics-based differences.

Animals↗

PubMed2006

Oral purified bacterial extracts in acute respiratory tract infections in childhood: a systematic quantitative review.

BACKGROUND: Recurrent acute respiratory tract infections (ARTI) are a common problem in childhood. Some evidence suggests a benefit regarding the prevention of ARTI in children treated with the immunomodulator OM-85 BV (Bronchovaxom). METHODS: We summarised the evidence on the effectiveness of the immunomodulator OM-85 BV in the prevention of ARTI in children. We searched randomised comparisons of oral purified bacterial extracts against inactive controls in children with respiratory tract diseases in nine electronic databases and reference lists of included studies. We extracted salient features of each study, calculated relative risks (RR) or weighted mean differences (WMD) and performed meta-analyses using random-effects models. RESULTS: Thirteen studies (2,721 patients) of low to moderate quality tested OM-85 BV. Patients and outcomes differed substantially, which impeded pooling results of more than two trials. Two studies (240 patients) reporting on the number of patients with less than three infections over 6 month of follow-up in children not in day care showed a trend for benefit RR 0.82 (95% CI, 0.65-1.02). One out of two studies examining the number of children not in day care without infections over 4-6 month reported a significant RR of 0.42 (95% CI, 0.21-0.82) whereas the smaller, second study did not [RR 0.92 (95% CI, 0.58-1.46)]. Two studies reporting the number of antibiotic courses indicated a benefit for the intervention arm [WMD 2.0 (95% CI, 1.7-2.3)]. Two out of the three studies showed a reduction of length of episodes of 4-6 days whereas a third study showed no difference between the two groups. CONCLUSION: Evidence in favour of OM-85 BV in the prevention of ARTI in children is weak. There is a trend for fewer and shorter infections and a reduction of antibiotic use.

Child↗

PubMedDate not supplied

Comparison of oral erythromycin ethylsuccinate and clavulanate-potentiated amoxicillin in the treatment of acute respiratory tract infections.

Seven hundred fifty patients with acute upper or lower respiratory tract infections were randomly assigned to receive 2 gm of erythromycin ethylsuccinate daily or 1.125 gm of clavulanate-potentiated amoxicillin daily in a single-blind, multicenter study. The efficacy of each formulation was similar, with close to 90% of patients in each treatment group being reported as either cured or improved. Gastrointestinal symptoms were the most commonly reported side effects, their overall incidence being similar in both treatment groups. However, diarrhea occurred more than twice as often in the amoxicillin group than the erythromycin group. In each group, the number of patients failing to complete treatment was similar; the main reasons cited for discontinuation were gastrointestinal symptoms. The results indicate that both erythromycin ethylsuccinate and clavulanate-potentiated amoxicillin are well tolerated and are equally effective for routine empirical treatment of acute respiratory tract infections.

Acute Disease↗

PubMed2006

Quantitative detection of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in lower respiratory tract samples by real-time PCR.

The limitation of polymerase chain reaction (PCR) in diagnosis of lower respiratory tract infections (LRTIs) caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis has been a distinguishing colonization from infection. We assess here the usefulness of real-time quantitative PCR (RQ-PCR) performed on lower respiratory tract samples to overcome this problem. Consecutive respiratory tract samples from patients with and without signs of infection (n = 203) were subjected to RQ-PCR, targeting the genes pneumolysin (S. pneumoniae), fumarate reductase (H. influenzae), and outer membrane protein B (M . catarrhalis). DNA from positive controls with predefined colony forming units (CFUs) per milliliter were included to allow estimation of CFU per milliliter for the test samples. In parallel, assessment of quantitative cultures from all samples was performed. In the group of patients with LRTI, significant pathogens (>/=10(5) CFU/mL) were found in 32/135 samples (23.7%) with culture, in 51/135 (37.7%) with RQ-PCR, and in 59/135 (43.7%) when combining the methods.

Bronchoalveolar Lavage Fluid↗

PubMed1983

Respiratory tract infections at a community care centre--with emphasis on group A streptococci.

Antibiotics were prescribed for 60% of 1538 patients who consulted a community care centre due to respiratory tract infections. Potential respiratory tract pathogens (betahaemolytic streptococci group A, C, G, Haemophilus influenzae, pneumococci) were isolated from almost half (46%) of the patients. The prescribing of antibiotics was correlated to the isolation of potentially pathogenic bacteria, except for patients with pharyngitis, sinusitis and bronchitis. Betahaemolytic streptococci group A were isolated from 14% of the patients. Recurrence of group A streptococcal infection occurred within 3 months in 24% of patients harbouring such bacteria at the first visit. Poststreptococcal subclinical acute glomerulonephritis (AGN) was diagnosed in 9 (4%) of 220 patients with group A streptococci. The patients with AGN had been treated with antibiotics significantly later than patients without signs of AGN.

Adolescent↗

PubMed1981

The role of the carrier in treatment failures after antibiotic for group A streptococci in the upper respiratory tract.

During a prospective study of endemic group A streptococcal upper respiratory tract infection and the streptococcal carrier state, we investigated persistence of group A streptococci after treatment with recommended doses of antibiotics. We evaluated clinical findings, culture results, and streptococcal antibody responses at the acute-stage clinic visit and at convalescent-stage visits 3 and 8 weeks later. Data from 280 children ill with pharyngitis and their family contacts were analyzed (mean age 13.3 years); 129 individuals (46%) had group A beta-hemolytic streptococci isolated at the initial visit. Despite antibiotic treatment, group A streptococci were not eradicated from the upper respiratory tract of 34 (26%) of the 129 culture-positive individuals. Thirteen of the 34 (38%) required a second course of antibiotic therapy before the infecting serotype was eradicated, but a majority, the remaining 21 (62%) patients, were not bacteriologically cured despite repeated courses of antibiotics. Streptococcal antibody data suggested that the majority of the treatment failures were streptococcal carriers. Only 5% of asymptomatic individuals with a positive culture for group A streptococci demonstrated an antibody rise. These bacteriologic and serologic data document that it usually is unnecessary to retreat asymptomatic convalescent individuals having throat cultures persistently positive for group A streptococci, since these individuals seldom represent true streptococcal infection.

Adolescent↗