Antibacterial therapy of community-acquired chest infections

Davies, A.C.; Jolley, Alan

doi:10.1093/jac/29.1.1

Cited by 11 publications

(4 citation statements)

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“…An increase in MICs was observed only for AZI in cultures of S. pyogenes. This phenomenon has already been observed both in vitro and in vivo [11,14]. Both drugs achieved concentrations high enough to eradicate the bacteria, but CLA levels fell off more rapidly compared to azithromycin.…”

Section: Discussionsupporting

confidence: 54%

In vitro Comparative Dynamics of Modified-Release Clarithromycin and of Azithromycin

Scaglione

Demartini²,

Dugnani³

et al. 2000

Chemotherapy

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Antibacterial kinetics of modified-release clarithromycin (CLA) and azithromycin (AZI) against respiratory tract pathogens were compared in relation to their pharmacokinetic profile. The study was carried out in three strains of Streptococcus pneumoniae, group A β-hemolytic Streptococcus pyogenes, Moraxella catarrhalis and Haemophilus influenzae, respectively, exposed to concentration gradients of CLA and AZI simulating human serum pharmacokinetics after administration of 500 mg p.o. in a single dose. Bactericidal kinetics were assessed by counting the number of survivors before each change in concentration over a period of 36 h. The minimal inhibitory concentrations (MICs) of CLA and AZI were evaluated at time 0 and after 36 h of exposure to antibiotics in the surviving organisms. The results showed that CLA and AZI, in the experimental conditions adopted, had different antibacterial kinetics. Moreover, the addition of the 14-OH metabolite of CLA at the same concentrations reached in human serum exerted a bactericidal effect against two strains of H. influenzae resistant to CLA and AZI. An increase in MICs was observed against S. pyogenes and H. influenzae, with higher values for AZI.

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Section: Discussionsupporting

confidence: 54%

In vitro Comparative Dynamics of Modified-Release Clarithromycin and of Azithromycin

Scaglione

Demartini²,

Dugnani³

et al. 2000

Chemotherapy

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“…Increasingly, expensive intravenous antibiotics—in particular, third generation cephalosporins—are being used as drug of first choice in uncomplicated respiratory tract infections1 12 with few data to suggest that they are more efficacious 13. This study of the outcome and economics of common antibiotic regimens evaluated current practice in our and, we believe, many other hospitals 12.…”

Section: Discussionmentioning

confidence: 99%

Oral versus intravenous antibiotics for community acquired lower respiratory tract infection in a general hospital: open, randomised controlled trial

Chan

Hemeryck

O’Regan³

et al. 1995

BMJ

104

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Key messages * Osteoporosis is a disease characterised by low bone mineral density, 80% of which is under genetic control * Vitamin D has an important role in the metabolism of calcium and bone, mediated through its receptor * Common variants of the vitamin D receptor gene are responsible for 7-10% of the difference in bone density between women after the menopause * This genetic marker is important because of its potential role in identifying individual women at increased risk of fracture before menopause and in selecting optimal treatment selecting optimal treatment based on the understanding of pathophysiological mechanisms. Because of discrepancies between population groups, further studies are needed, with larger sample sizes that include a range of ages in both men and women. The demonstration of the effect of these common vitamin D receptor genotypes on bone mineral density in a second, geographically distinct population of older and postmenopausal women opens the way to a wide range of studies to provide novel approaches to the prevention and treatment of osteoporosis. Design-Open controlled trial in patients admitted consecutively and randomised to treatment with either oral co-amoxiclav, intravenous followed by oral co-amoxiclav, or intravenous followed by oral cephalosporins.Setting-Large general hospital in Dublin. Patients-541 patients admitted for lower respiratory tract infection during one year. Patients represented 87% of admissions with the diagnosis and excluded those who were immunocompromised and patients with severe life threatening infection.Main outcome measures-Cure, partial cure, extended antibiotic treatment, change of antibiotic, death, and cost and duration ofhospital stay.

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“…The use of antibiotics in the treatment of infective exacerbations of chronic obstructive airways disease (COAD) is controversial and opinions vary as to which agent should be used for therapy (Anonymous, 1987;Anthonisen et al, 1987;Rodnick & Gude, 1988;van der Meer, 1989;Bannister, 1990;Gross, 1990;Chodosh, 1991;Davies & Jolley, 1992;Dere, 1992), and even as to whether all patients with exacerbations actually require any antibiotic treatment (Anthonisen et al, 1987). There is general agreement that patients who are hospitalised with exacerbations of COAD should receive a drug which is active against the two most important pathogens, Haemophilus influenzae and Streptococcus pneumoniae (Anthonisen et al, 1987;Rodnick & Gude, 1988;Bannister, 1990;Gross, 1990;Chodosh, 1991;Dere, 1992).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronic obstructive airways disease in a hospital respiratory unit

Boyter¹,

Davey²,

Hudson

et al. 1995

J Antimicrob Chemother

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A prescribing protocol for infective exacerbations of chronic obstructive airways disease (COAD), specifying the use of oral amoxycillin 500 mg tid (or erythromycin 500 mg qid if allergic) as first line therapy, and oral ciprofloxacin 500 mg bd as second line treatment, was introduced in 1991. Every third sequential admission was screened for the year preceding (1990) and the year after (1991) the protocol was implemented. Only those patients with a discharge diagnosis of infective exacerbation of COAD, but without pneumonia, were included in the analysis. The two groups (1990 and 1991) were matched in terms of age, sex and pre-treatment given by their General Practitioner (GP), but differed with respect to severity score, with 1991 being more severe. The outcome measures showed that duration of hospital stay was comparable as was duration of treatment. Response to first line therapy was 68% and 67% for 1990 and 1991, respectively. Of those who had received antibiotics from their GP, 67% responded to first line therapy, while of those who had not received antibiotics from their GP 75% responded. Duration of therapy was shorter in first line responders (mean and 95% CI: 7.3 (6.3-8.3) days vs 12.7 (10.1-15.3) days). The mean cost per day antibiotic treatment was reduced by 54.6% (95% CI 52.3-56.9%) from 3.77 pounds to 1.71 pounds. In conclusion, the introduction of antibiotic prescribing guidelines for treatment of infective exacerbations of COAD showed no detrimental effect on outcome measures, but was associated with a significant reduction in the cost of antibiotic therapy.

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Antibacterial therapy of community-acquired chest infections

Cited by 11 publications

References 0 publications

In vitro Comparative Dynamics of Modified-Release Clarithromycin and of Azithromycin

In vitro Comparative Dynamics of Modified-Release Clarithromycin and of Azithromycin

Oral versus intravenous antibiotics for community acquired lower respiratory tract infection in a general hospital: open, randomised controlled trial

Evaluation of an antibiotic prescribing protocol for treatment of acute exacerbations of chronic obstructive airways disease in a hospital respiratory unit

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