Bronchitis acute exacerbation

Otitis media, acute bronchitis, acute exacerbations of chronic bronchitis, pharyngitis, tonsillitis, and uncomplicated UTIs PO 400 mg/day as a single dose or in 2 divided doses. 

Sethi S, Murphy TF. Acute exacerbations of chronic bronchitis new developments concerning microbiology and pathophysiology— impact on approaches to risk stratification and therapy. Infect Dis Clin North Am 2004 18 861-882. 

An increased number of polymorphonuclear granulocytes in sputum often suggests continual bronchial irritation, whereas an increased number of eosinophils may suggest an allergic component. The most common bacterial isolates (expressed in percentages of total cultures) identified from sputum culture in patients experiencing an acute exacerbation of chronic bronchitis are as follows ... 

The goals of therapy for chronic bronchitis are to reduce the severity of symptoms, to ameliorate acute exacerbations, and to achieve prolonged infection-free intervals. 

The most common cause of acute respiratory failure in COPD is acute exacerbation of bronchitis with an increase in sputum volume and viscosity. This serves to worsen obstruction and further impair alveolar ventilation, resulting in worsening hypoxemia and hypercapnia. Additional causes are pneumonia, pulmonary embolism, left ventricular failure, pneumothorax, and CNS depressants. 

A further example of the ability of doxycycline to penetrate into secretions is provided by a report [53] of a comparative trial of the drug and ampicillin in acute exacerbations in chronic bronchitis. It was found that 100 mg doxycycline daily and ampicillin 250 mg four times daily were clinically equally effective. Bacterio-logically, however, it was found that H. influenzae re-appeared in sputum more often during ampicillin therapy than y ith doxycycline. This was attributed, following earlier workers, to the failure of ampicillin (in the dose used) to reach adequate levels in sputum. By inference, therefore, doxycycline (at one tenth of the daily dosage) achieves adequate levels more readily. 

Safety and efficacy of drug administered less than 10 days in patients with acute exacerbations of chronic bronchitis have not been established. 

Acute exacerbations of chronic bronchitis in adults - Acute exacerbations of chronic bronchitis in adults caused by susceptible strains of/-/, influenzae and S. pneumoniae. 

Un, acute exacerbation of chronic bronchitis prophylaxis in transurethral procedures Action Quinolone antibiotic -1- DNA gyrase. Dose 400 mg/d PO X w/ renal insuff, avoid antacids Caution [C, —] Interactions w/ cation-containing products Contra Quinolone all gy, children <18 y,T QT interval, X Disp Tabs SE NA/ /D, abd pain, photosens, Szs, HA, dizziness, tendon rupture, periph al neuropathy, pseudomembranous cohtis, anaphylaxis Interactions t Effects W/ cimetidine, probenecid T effects OF cyclosporine, warfarin, caffeine X effects W/ antacids EMS Monitor ECG for TqT int val, esp in pts taking class lA/III antiarrhythmics monitor ECG and BP for signs of h5 povolemia and electrol5rte disturbances (hypokalemia) d/t D T risk of photosensitivity Rxns OD May cause NA /D, confusion and Szs symptomatic and supportive... 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

Acute exacerbation of chronic Bronchitis PO 300 mg ql2h for 5-10 days. 

Acute exacerbation of chronic bronchitis PO 400 mg twice a day for 10 days. Community-acquired pneumonia PO 400 mg 2 twice a day for 14 days. 

Lower respiratory tract infections e.g., pneumonia, acute bronchitis and acute exacerbations of chronic bronchitis. 

Pneumonia, acute bronchitis and acute exacerbation of chronic bronchitis. 

Indications IV Infusion Prophylaxis and treatment of Pneumocystis car/n/ pneumonia Shigellosis Severe or complicated urinary tract infections Tablets Prophylaxis and treatment of Pneumocystis carinii pneumonia Acute exacerbation of chronic bronchitis Urinary tract infections Travelers diarrhea in adults Shigellosis Acute otitis media ... 

Generation] Uses Acute exacerbations of chronic bronchitis, pharyngitis, tonsillitis skin Infxns Action 3rd-gen cephalosporin X cell wall synth Dose Adults Peds >12 y Skin 200 mg PO bid x 10 d Chronic bronchitis, pharyngitis, tonsillitis 400 mg PO bid x 10 d avoid antacids w/in 2 h take w/ meals X in renal impair Caution [B, ] Renal/hepatic impair Contra Cephalosporin/PCN allergy, milk protein, or carnitine deficiency Disp Tabs SE HA, N/V/D, colitis, nephrotox,... 

Oral bioavailability is 57%, and tissue and intracallular penetration is generally good. Telithromycin is metabolized in the liver and eliminated by a combination of biliary and urinary routes of excretion. It is administered as a once-daily dose of 800 mg, which results in peak serum concentrations of approximately 2 g/mL. Telithromycin is indicated for treatment of respiratory tract infections, including community-acquired bacterial pneumonia, acute exacerbations of chronic bronchitis, sinusitis, and streptococcal pharyngitis. Telithromycin is a reversible inhibitor of the CYP3A4 enzyme system. 

Community-acquired pneumonia, acute exacerbation of chronic bronchitis, other lower gonococcal and nongonococcal burethritis in complicated UTI Immunomodulator Anti-HIV... 

Ball P, Make B. Acute exacerbations of chronic bronchitis an international comparison. Chest, 1998, 113 (3 Suppl.), 199S-204S. 

Wilson R, et al. Short-term and longterm outcomes of moxifloxacin compared to standard antibiotic treatment in acute exacerbations of chronic bronchitis. Chest, 2004, 125, 953—964. 

Qll Acute exacerbations of chronic bronchitis can be caused either by viral or bacterial infections. Production of thick, green sputum suggests Chandra has a bacterial infection. Common bacterial pathogens affecting the lung include Streptococcus pneumoniae and Haemophilus influenzae. It is recommended that COPD patients receive influenza vaccine each year pneumoccocal vaccine is also often recommended in chronic lung disease and may prevent recurrence of chest infection in the elderly. 

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