Moraxella catarrhalis infections acute exacerbation

The major precipitants of exacerbations of COPD are acute airways infections. The role of bacteria in precipitating exacerbations is controversial. Bacteria may have a primary role in the development of an exacerbation or represent a secondary superinfection of an initial viral process. The major bacterial organisms that have been associated with exacerbations are Haemophilus influenzae. Streptococcus pneumoniae, and Moraxella (Branhamella) catarrhalis. Mycoplasma pneumoniae and Chlamydia pneumoniae may play a part. In COPD patients with a FEVi < 35% predicted gram-negative bacteria, especially Enterobacteriaceae and Pseudomonas spp. play an important part in acute exacerbations. 

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. 

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. 

Lomefloxacin, a fluoroquinolone broad-spectrum antibiotic (400 mg p.o. daily for 10 to 14 days), is used in acute bacterial exacerbations of chronic bronchitis caused by Haemophilis influenzae or Moraxella (Branhamella) catarrhalis in uncomphcated urinary tract infections (cystitis) caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Staphylococcus saprophyticus, in complicated urinary tract infections caused by E. coli, K. pneumoniae, P. mirabilis, and Pseudomonas aeruginosa and it is possibly effective against infections caused by Citrobacter diversus or Enterobacter cloacae and for the prophylaxis of infections after transurethral surgical procedures (see also Figure 85). 

---