Erythromycin in legionnaires' disease: a re-appraisal

Miller, Asaf

doi:10.1093/jac/7.3.217

Cited by 22 publications

(3 citation statements)

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“…The conventional 'in vitro' means of ap praisal of antibiotic activity, such as MIC or MBC, are not predictive of the 'in vivo' effi- cacy of antibiotics given in legionnaires' dis ease for the following reasons: L. pneumo phila is a facultative intracellular parasite [10], and thus some antibiotics that are active 'in vitro' are not active 'in vivo' because their cel lular permeability is poor, e.g., ß-lactam anti biotics [11]; the media used to culture the mi croorganism inhibit the activity of some anti biotics [12][13][14][15], A limited number of antibiotics have been shown to be active in animal and cell infection models [16][17][18] and in patients [19,20], These include macrolides, rifampin, and new fluoroquinolones. Based on 'in vitro' [13][14][15][16], animal model [17,18], and clinical ob servations [19][20][21], erythromycin remains the treatment of choice in patients suffering from legionellosis.…”

Section: Discussionmentioning

confidence: 99%

“…Based on 'in vitro' [13][14][15][16], animal model [17,18], and clinical ob servations [19][20][21], erythromycin remains the treatment of choice in patients suffering from legionellosis. However, reservations have been expressed by some clinicians [20] about its use. In fact, patients with impaired host defense mechanisms suffering from legion naires' disease have been observed not to re spond to erythromycin therapy, and this is probably due to the fact that erythromycin is bacteriostatic rather than bactericidal and that clearance of the organism is dependent on an effective immune defense mechanism…”

Section: Discussionmentioning

confidence: 99%

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In vitro Activity of Rufloxacin against Listeria monocytogenes, Legionella pneumophila, and Chlamydia trachomatis

Furneri

M²,

Campo³

et al. 1994

Chemotherapy

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The in vitro activity of a new fluorquinolone, rufloxacin, was determined against both clinical isolates and standard strains of Legionella pneumophila, Chlamydia trachomatis, and Listeria monocytogenes and compared to that of ciprofloxacin, ofloxacin, and erythromycin. Among the antibacterials tested erythromycin was the most active. Rufloxacin inhibited the growth of L. pneumophila at concentrations in the range of 0.06-0.25 mg/l, that of C. trachomatis at concentrations in the range of 2-4, and that of L. monocytogenes at concentrations in the range of 1-2 mg/l. Rufloxacin demonstrated approximately the same activity as ciprofloxacin against C. trachomatis, but twice as less potency as ofloxacin and erythromycin against L. pneumophila, L. monocytogenes, and C. trachomatis, and twice as less potency as ciprofloxacin against L. pneumophila.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

In vitro Activity of Rufloxacin against Listeria monocytogenes, Legionella pneumophila, and Chlamydia trachomatis

Furneri

M²,

Campo³

et al. 1994

Chemotherapy

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“…98 The cadre of Legionnaires' disease experts in Nottingham, such as Dr Dewi Davies and Dr Andrew Miller, led the calls to rethink the management of all pneumonias. 99 General practitioners were also advised to consider Legionnaires' disease when seeing a patient with pneumonia. In a 1983 article in The Practitioner, John Macfarlane, wrote that, 'If recovery [from pneumonia] is slow but the patient not seriously ill, an atypical pneumonia [such as Legionnaires' disease] is a possibility and a change to Erythromycin should be considered.'…”

Section: The Clinical Responsementioning

confidence: 99%

Showers, Sweating and Suing: Legionnaires’ Disease and ‘New’ Infections in Britain, 1977–90

Macfarlane¹,

Worboys²

2012

Med. Hist.

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Legionnaires' disease is now routinely discussed as an 'emerging infectious disease' (EID) and is said to be one of the earliest such diseases to be recognised. It first appeared in 1976 and its cause was identified in 1977, the same year that Ebola fever, Hantaan virus and Campylobacter jejuni arrived. The designation of Legionnaires' disease as an EID was retrospective; it was not and could not be otherwise as the category only gained currency in the early 1990s. In this article we reflect on the changing medical understanding and social profile of Legionnaires' disease in the decade or so from its recognition to the creation of EIDs, especially its ambivalent position between public health and clinical medicine. However, we question any simple opposition, between public health experts who approached Legionnaires' disease as a new and worrying environmental threat that could be prevented, and clinicians who saw it as another cause of pneumonia that could be managed by improved diagnosis and treatment. We argue that in the British context of public spending cuts and the reform of public health, the category of 'new' diseases, in which Legionnaires' disease was central, was mobilised ahead of the EID lobby of the early 1990s, by interested groups in medicine to defend infectious diseases services.

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Pneumonia

Seaton¹

2000

Crofton and Douglas's Respiratory Diseases

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Erythromycin in legionnaires' disease: a re-appraisal

Cited by 22 publications

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In vitro Activity of Rufloxacin against <i>Listeria monocytogenes</i>, <i>Legionella pneumophila</i>, and Chlamydia trachomatis

In vitro Activity of Rufloxacin against <i>Listeria monocytogenes</i>, <i>Legionella pneumophila</i>, and Chlamydia trachomatis

Showers, Sweating and Suing: Legionnaires’ Disease and ‘New’ Infections in Britain, 1977–90

Pneumonia

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