Thirty-four patients with community-acquired acute pneumonias were treated in a prospective, randomized trial with either cefadroxil, 500 mg twice daily, or cephalexin, 250 mg four times daily. In both groups of patients, the presence of chronic illnesses predisposing to pneumonia was common. Streptococcus pneumoniae was isolated from 65% of the initial sputum specimens, and most illnesses were of mild to moderate severity. All 19 cases treated with cefadroxil and all 15 cases treated with cephalexin were clinically cured, and adverse reactions to the medications were minimal. The success of these regimens suggests that outpatient use of oral cephalosporin therapy may be an appropriate treatment of patients with mild or moderate community-acquired pneumonia.
Mycoplasma pneumoniae attaches to a variety of surfaces. Adherence to inert surfaces such as glass requires an intact energy metabolism. Interaction with sheep erythrocytes occurs via a binding protein on the mycoplasma surface. The protein reacts with a receptor containing sialic acid. Adherence to other erythrocytes may involve different mechanisms. Different results have been reported on interaction with tissue cells. The various mechanisms probably cooperate and thereby facilitate the colonization of the human respiratory tract.
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