Penicillins respiratory tract infections

A patient who is taking phenytoin and is hypersensitive to penicillin requires a broad-spectrum antibacterial agent for a respiratory tract infection. 

In patients allergic to penicillin, macrolides are usually indicated in mild respiratory tract infections. Zithromax contains azithromycin, which is a macrolide that may be indicated for respiratory tract infections. As opposed to clarithromycin (another macrolide), azithromycin does not present any significant clinical interaction with phenytoin. Ciproxin contains ciprofloxacin. 

Which one of the following is the most appropriate for the management of an upper respiratory tract infection in a patient who is allergic to penicillin ... 

First-line treatment in upper respiratory tract infections includes the use of penicillins, cephalosporins and mocrolides. Patients who are allergic to penicillins tend to be cross-sensitive to cephalosporins, so ore given mocrolides such as clarithromycin. 

Severe staphylococcal Infections - Severe staphylococcal infections (including methicillin-resistant staphylococci) in patients who cannot receive or who have failed to respond to penicillins and cephalosporins, or who have infections with resistant staphylococci. Infections may include endocarditis, bone infections, lower respiratory tract infections, septicemia, and skin and skin structure infections. 

Others. Leoofloxacin (t) 7h) has greater activity against Streptococcus pneumoniae than ciprofloxacin and is used for respiratory and urinary tract infection. Moxifloxacin (t) 12 h) has strong anti-Gram-positive activity, and may prove useful for respiratory tract infections including those caused by atypical pathogens and penicillin-resistant Streptococcus pneumoniae. 

Moxifloxacin is an 8-methoxyquinolone with enhanced potency against important Gram-positive pathogens, notably Streptococcus pneumoniae (penicillin-resistant and penicillin-susceptible strains), and class activity against Gram-negative bacteria. Its activity is not affected by beta-lactamases. Moxifloxacin may therefore represent a promising alternative for treatment of respiratory tract infections (1). 

Claforan cefotaxime, clarithromycin [ban, inn, usan] (Blaxln Klaricid ) is the 6-0-methyl derivative of erythromycin, a macrolide, and has superior pharmacokinetic properties. It can be used clinically as an oral or parenteral antibacterial to treat a wide variety of infections, including skin, soft tissue and respiratory tract infections. It is usually given to patients who are allergic to penicillin. 

TICARCILLIN/CLAVULANATE POTASSIUM (Timentin powder for injection 3 g ticarcillin (as disodium) and 0.1 g clavulanic acid (as potassium) (contains 4.75 mEq sodium and 0.15 mEq potassium/g), injection solution 3 g ticarcillin (as disodium) and 0.1 g clavulanic acid (as potassium) per 100 mL (contains 18.7 mEq sodium and 0.5 mEq potassium per 100 mL)) Ticarcillin/clavulanate potassium is an extended-spectrum penicillin. Ticarcillin inhibits bacterial cell wall mucopep-tide synthesis. Clavulanate lactamase enzymes are commonly found in microorganisms resistant to ticarcillin. They are indicated in the treatment of bacterial septicemia, skin and skin structure infections, lower respiratory tract infections, bone and joint infections, GU and gynecologic infections, and intra-abdominal infections caused by susceptible strains of bacteria. 

Ticarcillin, extended-spectrum penicillin, alpha-carbox-ypenicillin, is indicated for the treatment of bacterial septicemia, skin and soft-tissue infections, acute and chronic respiratory tract infections caused by susceptible strains of Pseudomonas aeruginosa, Proteus species (both indole-positive and indole-negative), and Escherichia coli and for genitourinary tract infections (complicated and uncomplicated) due to susceptible strains of P. aeruginosa, Proteus species (both indole-positive and indole-negative), E. coli, Enterobacter, and Streptococcus faecalis (enterococcus). 

Bacitracin is mainly used for topical application. A great variety of ointments, solutions, troches and tablets are available for local application. For broadening of the antimicrobial spectrum it is very often combined with other antibiotics such as neomycin, penicillin, tyrothricin and polymixin. Topical administration is used against infections of the skin, eye, ear and throat, with little incidence of sensitization. Good results have been obtained in the prophylactic and active treatment of infected burns - . Inhalation has been reported for susceptible respiratory tract infections. Bacitracin appears to have some antihelminthic activity. ... 

Clarithromycin has been compared with amoxicillin suspension in the treatment of children with lower respiratory tract infections. No significant differences were seen between the groups with respect to clinical cure rates and incidence and severity of adverse events, which generally were mild [35], Five days of treatment with clarithromycin suspension was superior to 10 days of penicillin suspension in eradicating Streptococcus pyogenes in children with streptococcal pharyngitis [36]. 

Erythromycin A, the major fermentation component of S. erythraea, is a 14-membered ring macrolide that is used by medicinal chemists as the foundation for building semisynthetic derivatives of erythromycin antibiotics. (Macrohdes inhibit bacteria by interfering with microbial protein biosynthesis.) Semisynthetic macrolides are popular with clinicians because they can be administered orally and have relatively low toxicity. They are often used to treat respiratory tract infections, and have been especially effective against conditions such as Legionnaires disease and community-acquired pneumonia. Erythromycin therapy is often prescribed for individuals allergic to penicillin. One of the most widely used macrohde antibiotics... 

Before penicillin and the other antibiotics became generally available, the sulfonamides were the mainstay of antibacterial chemotherapy. They maintain a significant role, largely due to the use of a combination of sulfamethoxazole and trimethoprim (co-trimoxazole) for the treatment of bacterial respiratory tract infections and gastrointestinal infections. 

Norfloxacin (1, R = C2H5, R = H), a typical example, exhibits broad-spectrum activity and is useful in the treatment of upper respiratory tract and urinary infections [7] Lomefloxacin (2), a very recent introduction, is a third-generation product that, given once daily, is especially useful against pathogens resistant to cephalosponns, penicillins, and aminoglycosides [4] Floxacillin (J) is a stable, orally active antibacterial with improved activity over thenonfluonnated product (cloxacillin) [5]... 

The natural and semi ynthetic penicillins are used in tire treatment of bacterial infections due to susceptible microorganisms. Fbnicillins may be used to treat infections such as urinary tract infections, septicemia, meningitis, intra-abdominal infection, gonorrhea, syphilis, pneumonia, and other respiratory infections. Examples of infectious microorganisms (bacteria) that may respond to penicillin therapy include gonococci, staphylococci,... 

Due to its powerful specific activity against commonly isolated community-acquired respiratory tract pathogens [33,149-158], including penicillin-sensitive and -resistant Streptococcus pneumoniae, methicillin-sensitive Staphylococcus aureus, Haemophilus spp., Moraxella catarrhalis and atypical pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila and Klebsiella pneumoniae and anaerobic bacteria [159-162], moxifloxacin was developed as a respiratory tract anti-infective [163-168]. 

Moxifloxacin has a broad spectrum of activity which includes Gram-positive cocci, atypical pathogens and anaerobic bacteria responsible, inter alia, for infections of the respiratory tract. Moreover, moxifloxacin is one of the most effective fluoroquinolones against pneumococci, including the penicillin- and macrolide-resistant strains. The development of resistance to moxifloxacin is slower than that of the other fluoroquinolones. 

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