Pneumonia chlamydial

Suggested Alternatives for Differential Diagnosis Brucellosis, chlamydial pneumonias, infective endocarditis, legionnaires disease, mycoplasma infections, pneumonia, Cox-iella burnetii infection, Francisella tularensis infection, Q fever, tuberculosis, tularemia, typhoid fever, and all atypical pneumonia. 

Kalayoglu, M.V., and Byrne, G.I., 1998a, A Chlamydia pneumoniae component that induces macrophage foam ceU formation is chlamydial hpopolysaccharide, Infect. Immun. 66 5067-5072. 

Although erythromycin is a well-established antibiotic, there are relatively few primary indications for its use. These indications include the treatment of Mycoplasma pneumoniae infections, eradication of Corynebacterium diphtheriae from pharyngeal carriers, the early preparox-ysmal stage of pertussis, chlamydial infections, and more recently, the treatment of Legionnaires disease, Campylobacter enteritis, and chlamydial conjunctivitis, and the prevention of secondary pneumonia in neonates. 

Erythromycin Prevents bacterial protein synthesis by binding to the 50S ribosomal subunit Bacteriostatic activity against susceptible bacteria Community-acquired pneumonia t pertussis corynebacterial, and chlamydial infections Oral, IV hepatic clearance (half-life 1.5 h) dosed every 6 h cytochrome P450 inhibitor Toxicity Gastrointestinal upset, hepatotoxicity, QTC prolongation... 

Although the clinical usefulness of tetracyclines is limited for most of the common microbial pathogens, they remain drugs of choice (or very effective alternative therapy) for a wide variety of infections caused by less common pathogens. These include brucellosis rickettsial infections such as Rocky Mountain spotted fever, typhus, and Q fever Mycoplasma pneumonia cholera plague Ureaplasma urethritis Chlamydia infections and Lyme disease. Oral doxycycline, 100 mg orally twice a day for 7 days, is a recommended treatment for chlamydial sexually transmitted disease. 

Chlamydial infections can be treated effectively with any of the macrolides. A single 1-g dose of azithromycin is recommended for patients with uncomplicated urethral, endocervical, rectal, or epididymal infections because of the ease of compliance. During pregnancy, erythromycin base, 500 mg four times daily for 7 days, is recommended as first-line therapy for chlamydial urogenital infections. Azithromycin, 1 g orally as a single dose, is a suitable alternative. Erythromycin base is preferred for chlamydial pneumonia of infancy and ophthalmia neonatorum (50 mg/kg per day in four divided doses for 10 to 14 days). Azithromycin, 1 g a week for 3 weeks, may be effective for lymphogranuloma venereum. 

With increasing evidence for a causative association between Chlamydia pneumoniae and coronary heart disease, roxithromycin has been investigated for its anti-chlamydial and anti-inflammatory effects on clinical outcome in patients with unstable angina [172, 173]. Compared with placebo in a double-blind, randomized, prospective, multicenter trial, the drug given at 150 mg b.i.d. for 30 days... 

Hoffmeister, A., Rothenbacher, D., Wanner, P., Bode, G., Persson, K., Brenner, H., Hombach, V., and Koenig, W. 2000. Seropositivity to chlamydial lipopolysaccharide and Chlamydia pneumoniae, systemic inflammation and stable coronary artery disease Negative results of a case-control study. J. Am. Coll. Cardiol. 35, 112-118. 

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