Streptococcal pneumonia

D) Acute community-acquired streptococcal pneumonia treat accordingly. 

However, the central paradox in our consideration of inflammatory disease is that the inflammatory response evolved as a highly effective component of the innate immune response of the body to infection or injury. Indeed, until the last two or three decades, inflammation was perceived as an entirely beneficial host response to injury or infection. Elias Metchnikoff, the fether of modern inflammatory cell biology, emphasized this concept in his work. Neutrophil and eosinophil granulocytes play key defensive roles in infections such as lobar streptococcal pneumonia and in parasitic infestations such as schistosomiasis. The acute inflammatory response in... 

Figure 12.4 An electron micrograph of resolving experimental streptococcal pneumonia showing a macrophage...

Streptococcal pharyngitis (including scarlet fever) Streptococcal pneumonia, arthritis, meningitis, and endocarditis... 

Natural penicillin Infections like streptococcal pneumonia, enterococcal and nonenterococcal group D endocarditis, diphtheria, anthrax, meningitis, tetanus, botulism, actinomycosis, syphilis, and relapsing fever, Lyme disease prophylaxis against pneumococcal infections, rheumatic fever, bacterial endocarditis... 

Blood group determinant A Blood group determinant B Receptor for Streptococcous pneumoniae... 

Coffin DL, Blommer EJ. Acute toxicity of irradiated auto exhaust its indication by enhancement of mortality from streptococcal pneumonia. Arch Environ Health 1967 15 36-38. 

Macrolide Azithromycin, erithromycin, and telithromycin Streptococcal infections, lower and upper respiratory tract infections and pneumonia... 

This drug is effective for infections caused by streptococci, gonococci, pneumococci, staphylococci, and also colon bacillus. Sulfacytine is used for pneumonia, cerebral meningitis, staphylococcal and streptococcal sepsis, and other infectious diseases. A synonym of this drug is renoquid. 

Serious streptococcal infections, such 150,000 units/kg/day divided in as pneumonia and endocarditis (S. equal doses every 4 to 6 h pneumoniae) and meningococcus... 

It is clinically important to understand the nature of the mechanism of resistance to an antibiotic drug. For example, the -lactam resistance of Streptococcus pneumoniae is due to the appearance of altered penicillinbinding proteins. Thus, the use of a combination of a 3-lactam and a penicillinase inhibitor, such as clavulanate, wUl not overcome streptococcal -lactam resistance, because the mechanism of resistance is not due to the production of a penicillinase. 

Tetracyclines no longer can be entirely relied on in the treatment of streptococcal infections up to 40% of Streptococcus pyogenes and 10% of Streptococcus pneumoniae are resistant. 

Erythromycin is effective in the treatment and prevention of S. pyogenes and other streptococcal infections, but not those caused by the more resistant fecal streptococci. Staphylococci are generally susceptible to erythromycin, so this antibiotic is a suitable alternative drug for the penicillin-hypersensitive individual. It is a second-line drug for the treatment of gonorrhea and syphilis. Although erythromycin is popular for the treatment of middle ear and sinus infections, including H. influenzae, possible erythromycin-resistant S. pneumoniae is a concern. 

Benzathine penicillin and procaine penicillin G for intramuscular injection yield low but prolonged drug levels. A single intramuscular injection of benzathine penicillin, 1.2 million units, is effective treatment for 3-hemolytic streptococcal pharyngitis given intramuscularly once every 3-4 weeks, it prevents reinfection. Benzathine penicillin G, 2.4 million units intramuscularly once a week for 1-3 weeks, is effective in the treatment of syphilis. Procaine penicillin G, formerly a work horse for treating uncomplicated pneumococcal pneumonia or gonorrhea, is rarely used now because many strains are penicillin-resistant. 

Cefazolin penetrates well into most tissues. It is a drug of choice for surgical prophylaxis. Cefazolin may be a choice in infections for which it is the least toxic drug (eg, penicillinase-producing E coli or pneumoniae) and in persons with staphylococcal or streptococcal infections who have a history of penicillin allergy other than immediate hypersensitivity. Cefazolin does not penetrate the central nervous system and cannot be used to treat meningitis. Cefazolin is an alternative to an antistaphylococcal penicillin for patients who are allergic to penicillin. 

Even in the setting of a classic infectious disease for which isolation techniques have been established for decades (eg, pneumococcal pneumonia, pulmonary tuberculosis, streptococcal pharyngitis), the sensitivity of the culture technique may be inadequate to identify all cases of the disease. 

Oral bioavailability is 57%, and tissue and intracallular penetration is generally good. Telithromycin is metabolized in the liver and eliminated by a combination of biliary and urinary routes of excretion. It is administered as a once-daily dose of 800 mg, which results in peak serum concentrations of approximately 2 g/mL. Telithromycin is indicated for treatment of respiratory tract infections, including community-acquired bacterial pneumonia, acute exacerbations of chronic bronchitis, sinusitis, and streptococcal pharyngitis. Telithromycin is a reversible inhibitor of the CYP3A4 enzyme system. 

Increased in bacterial infections such as pneumonia, upper respiratory tract infection, bacterial meningitis, tonsillitis, gastroenteritis, enterocolitis, streptococcal infection, mononucleosis, lymphadenitis, conjunctivitis, and whooping cough. 

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