Moraxella catarrhalis infection, treatment

A combination of trimethoprim-sulfamethoxazole is effective treatment for a wide variety of infections including P jiroveci pneumonia, shigellosis, systemic salmonella infections, urinary tract infections, prostatitis, and some nontuberculous mycobacterial infections. It is active against most Staphylococcus aureus strains, both methicillin-susceptible and methicillin-resistant, and against respiratory tract pathogens such as the pneumococcus, Haemophilus sp, Moraxella catarrhalis, and Klebsiella pneumoniae (but not Mycoplasma pneumoniae). However, the increasing prevalence of strains of E coli (up to 30% or more) and pneumococci that are resistant to trimethoprim-sulfamethoxazole must be considered before using this combination for empirical therapy of upper urinary tract infections or pneumonia. 

Starting in the 1920s, very many different mixed bacterial vaccine products (including inactivated bacteria such as Staphylococcus aureus. Streptococcus species. Streptococcus pneumoniae, Moraxella catarrhalis, Klebsiella pneumoniae, H. influenzae) were marketed worldwide. Currently, there are still several products available in European countries, and one product in the USA. Most vaccines have been used for treatment of recurrent and chronic infections of the respiratory tract. The efficacy of these products is doubtful. Delayed hypersensitivity to bacterial products is common. Delayed reactions, sometimes associated with vague malaise or myalgia, can occur after the administration of maintenance doses for months. If delayed skin reactions are accompanied by any systemic symptoms, administration of the mixed vaccine should be drastically reduced or stopped (87). 

S. pyogenes, H. influenzae, H. parainfluenzae, and Moraxella catarrhali. Cefditoren pivoxil is only indicated for the treatment of mild-to-moderate pharyngitis, tonsillitis, uncomplicated skin and skin structure infections, and acute exacerbations of chronic bronchitis. 

Trimethoprim and sulfamethoxazole (TMP-SMZ) This important drug combination is currently accepted treatment for complicated urinary tract infections and for respiratory, ear, and sinus infections due to H influenzae and Moraxella catarrhalis. In the immunocompromised patient, TMP-SMZ is used for infections due to Aeromonas hydrophila and is the drug of choice for prevention and treatment of pneumocystis pneumonia. TMP-SMZ is a possible backup drug for typhoid fever and shigellosis and has been used in the treatment of infections caused by methicillin-resistant staphylococci and Listeria monocytogenes. 

Azithromycin, an azalide macrolide antibiotic (500 mg p.o. as a single dose on day 1, followed by 250 mg daily on days 2 to 5 total accumulation dose is 1.5 g), is indicated in the treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or S. agalactiae second-line therapy of pharyngitis or tonsillitis caused by S. pyogenes and in nongonococcal urethritis or cervicitis caused by Chlamydia trachomatis. 

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