Bronchitis, antibiotic treatment

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. 

Routine use of antibiotics in the treatment of acute bronchitis is discouraged however, in patients who exhibit persistent fever or respiratory symptomatology for more than 4 to 6 days, the possibility of a concurrent bacterial infection should be suspected. 

Oral Antibiotics Commonly Used for the Treatment of Acute Respiratory Exacerbations in Chronic Bronchitis... 

Is treatment with an antibiotic necessary An important problem in the primary health care setting is treatment of mild upper RTI with antibiotics. It is well known that >90% of these upper RTI are caused by viruses and in these cases antibiotics are useless, even harmful. The benefit of antibiotics for exacerbations of chronic bronchitis is controversial. 

The use of antimicrobials for chronic bronchitis is controversial. Numerous comparative evaluations, including placebo-controlled smdies of antibiotic administration with acute and chronic treatment of chronic bronchitics, have suggested definite clinical benefit, whereas other similar studies have The antibi-... 

Traditionally, ampicillin has been considered the drug of choice for the treatment of acute exacerbations of chronic bronchitis. Unfortunately, the need for multiple repeat daily doses (four times daily), increased incidence of gastrointestinal side effects, and the increasing incidence of penicillin-resistant /3-lactamase-producing strains of bacteria (see Tables 106-2 and 106-4) have limited the usefulness of this safe and very cost-effective antibiotic. As stated earlier, the proposed classification system outlined in Table 106-2 offers first-and second-line treatment options for acute exacerbations of chronic bronchitis that are directed by the baseline clinical status of the patient. These treatment recommendations can be used to initiate therapy in patients with class I through IV disease. 

Ceflxime, a third-generation cephalosporin antibiotic (400 mg p.o. daily in 1 to 2 doses), is indicated in the treatment of otitis media, acute bronchitis, acute exacerbations of chronic bronchitis, pharyngitis, and tonsillitis. 

Cefprozil, a second-generation cephalosporin antibiotic, is indicated in the treatment of pharyngitis or tonsillitis caused by S. pyogenes otitis media caused by S. pneumoniae, H. influenzae, and M.(Branhamella) catarrhalis in secondary bacterial infections of acute bronchitis and acute bacterial exacerbation of chronic bronchitis caused by S. pneumoniae, H. influenzae, and M. (B.) catarrhalis and in uncomplicated skin and skin-strnctnre infections caused by Staphylococcus aureus and S. pyogenes. 

Levofloxacin is a fluoroquinolone/ophthalmic/antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, nosocomial pneumonia, community-acquired pneumonia, skin and skin structure infections, chronic bacterial prostatitis, urinary tract infection (UTI), inhalational anthrax (postexposure), and acute pyelonephritis caused by susceptible strains of specific microorganisms. Ophthalmic use is for the treatment of conjunctivitis caused by susceptible strains of aerobic Gram-positive and aerobic Gram-negative microorganisms. 

Loracarbef, a synthetic beta lactam antibiotic of the car-bacephem class (200 to 400 mg p.o. q. 12 hours), is used in the treatment of secondary bacterial infections of acute bronchitis, acute bacterial exacerbations or chronic bronchitis, of pneumonia, pharyngitis, tonsillitis, sinusitis, acute otitis media, uncomplicated skin and skin-structure infections, impetigo, uncomplicated cystitis, and in uncomplicated pyelonephritis. 

Numerous studies have compared azithromycin with other antibiotics in the treatment of LRTIs. One study demonstrated that the efficacy of a 5-day azithromycin regimen was comparable to a 7- to 10-day course of erythromycin or amoxicillin [233]. Other studies have shown that a 5-day course of azithromycin was as effective as a 10-day course of cefaclor [234, 235] or co-amoxiclav [236] in the treatment of LRTIs, which included cases of CAP and AIECB. Several studies of AIECB, CAP, and/or acute bronchitis have shown that a short course of azithromycin is equivalent to a 10-day course of co-amoxiclav [237], a 10-day course of clarithromycin [238], or a 10-day course of roxithromycin [151]. A comparative study of weekly azithromycin (500 mg/week) with I.M. benzathine penicillin G (1.2 MU, once) in military recruits revealed that azithromycin was more effective than benzathine penicillin G in the prevention of respiratory infections caused by typical bacterial pathogens [239]. 

Tetracyclines a group of antibiotics from various Streptomyces spp. T. contain four linearly fused six-membered rin individual T. differ according to the nature of substituents (Fig. and Table). T. inhibit protein biosynthesis by preventing the binding of ami-noacyl-tRNA to ribosomes. Next to the penicillins, T. were one of the most widely used antibiotics, particularly in the treatment of bronchitis, pneumonia, bile duct and urinary infections, plague and cholera. They are also widely employed as additives in animal feed-stuffs. On account of side reactions and increasing resistance of bacteria to T. their use is declining. 

Propanoyl, salt with mercaptobutane-dioic acid RVll. Zalig [84252-06-2] Antibiotic used in the treatment of chronic bronchitis. 2 -Propanoyl, compd. with N-acetyl-L-cy-steine (1 1) Eryth omytm stinoprate, INN [84252-03-9]... 

Antibiotic concentrations in respiratory secretions following systemic administration (oral or parenteral) may be inadequate for rapid treatment of airway disease such as tracheitis or bronchitis (71). Administration of antibiotics by aerosol has been used successfully and safely in children with cystic fibrosis and in infants and children who have endotracheal or tracheostomy tubes (72-74). Nebulization of antibiotic solutions allows delivery of high concentrations of antibiotics (10-40 times greater than following parenteral... 

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