Preliminary Data on the Action of Nesosteine, a Mucomodifying Drug, on Mucociliary Transport

1987 ◽  
Vol 15 (1) ◽  
pp. 57-61 ◽  
Author(s):  
P. C. Braga ◽  
R. Bossi ◽  
C. L. Castiglioni ◽  
S. Romandini ◽  
L. Allegra
Keyword(s):  
Oral Administration ◽  
Chronic Bronchitis ◽  
Preliminary Data ◽  
Mucociliary Clearance ◽  
Mucociliary Transport ◽  
Relative Speed ◽  
End Of Treatment ◽  
Acute Exacerbations ◽  
Before And After ◽  
Frog Palate

Nesosteine, which is active on airway secretions, has been studied by assessment of the mucociliary clearance of the frog palate. Sputum was collected from patients admitted to hospital with acute exacerbations of chronic bronchitis with mucous expectoration. The relative speed of transport was measured for each patient before and after oral administration of 600mg/day nesosteine. A significant increase in the mucus transport rate was found at the end of treatment

Azithromycin versus Pivampicillin in the Treatment of Acute Exacerbations of Chronic Bronchitis: A Single-Blind, Double-Dummy, Multicentre Study

2000 ◽  
Vol 28 (3) ◽  
pp. 101-110 ◽  
Author(s):  
P Schouenborg ◽  
N Gerdes ◽  
HH Rasmussen ◽  
N Wickers-Nielsen ◽  
E Mathiassen
Keyword(s):  
Multicentre Study ◽  
Chronic Bronchitis ◽  
Clinical Symptoms ◽  
Clinical Success ◽  
Well Being ◽  
End Of Treatment ◽  
Acute Exacerbations ◽  
Single Blind ◽  
Oral Azithromycin

This single-blind, double-dummy, multicentre study compared oral azithromycin, administered as tablets, 500 mg once daily for 3 days, versus oral pivampicillin, 700 mg twice daily for 10 days, in adults with acute exacerbations of chronic bronchitis (not needing parenteral antibiotic therapy, hospitalization or oxygen support). Clinical success (cure + improvement) rates were similar for both groups at the end of treatment (day 10; azithromycin, 124 of 133 [93%]; pivampicillin, 79 of 92 [86%]) and at follow-up (day 52; 98 of 126 [78%] versus 66 of 81 [81%]). The treatments produced similar levels of pathogen eradication at the end of treatment (49 of 54 [91%] versus 32 of 37 [86%]). Azithromycin-treated patients had significantly reduced chest discomfort at the end of treatment, and a trend towards improved lung function. The two groups were similar with respect to improvements in other clinical symptoms and patient well-being, and to the incidences of adverse events and treatment discontinuations. This oral azithromycin regime is an effective treatment for acute exacerbations of chronic bronchitis, similar in efficacy to the longer pivampicillin regime and may offer superior patient compliance.

The Retention of Lung Secretions during the Night in Normal Subjects

1978 ◽  
Vol 55 (6) ◽  
pp. 523-527 ◽  
Author(s):  
J. R. M. Bateman ◽  
D. Pavia ◽  
S. W. Clarke
Keyword(s):  
Diurnal Variation ◽  
Chronic Bronchitis ◽  
Mucociliary Clearance ◽  
Normal Subjects ◽  
Early Morning ◽  
Normal Male ◽  
Related Phenomenon ◽  
Before And After ◽  
Male Subjects

1. Mucociliary clearance has been measured over a 6 h period by using the radioaerosol technique in seven normal male subjects lying supine, both during the day when awake, and during the night when asleep. 2. The percentage of radioaerosol cleared during the night, when asleep, was significantly less than during the day when awake (P < 0.02). 3. A comparison of radioaerosol clearance before and after the time of onset of sleep demonstrates that reduced clearance occurred during sleep, indicating that this is probably a sleep-related phenomenon and not merely a result of diurnal variation. 4. This finding has important implications for patients with chronic bronchitis or asthma, in whom early morning cough or wheeze may be a predominant feature.

Mucus-depleted frog palate as a model for the study of mucociliary clearance

1990 ◽  
Vol 69 (2) ◽  
pp. 424-429 ◽  
Author(s):  
B. K. Rubin ◽  
O. Ramirez ◽  
M. King
Keyword(s):  
Viscoelastic Properties ◽  
Rana Pipiens ◽  
Mucociliary Clearance ◽  
Transport Rate ◽  
Leopard Frog ◽  
Mucociliary Transport ◽  
Percent Solid ◽  
Frog Palate ◽  
The Stability ◽  
Solids Content

To better understand the frog palate model of mucociliary transport, we measured the transport rate of mucus (MTR) from the leopard frog, Rana pipiens, and from the bullfrog, R. catesbeiana, recorded the stability of the MTR over a period of hours and days and over the course of 1 yr, and measured the viscoelasticity, percent solid composition, and spinnability (filance) of mucus from both species. Bullfrog mucus was less rigid than leopard frog mucus (log G* at 1 rad/s 2.09 vs. 2.61; P less than 0.01) and had a higher viscosity-to-elasticity ratio (tan delta at 1 rad/s 0.36 vs. 0.26; P less than 0.05). It also had a lower solids content (8.71 vs. 13.72%; P = 0.02), and there was a trend to lower spinnability for bullfrog mucus (filance 26.7 vs. 33.5 mm). These data suggest that bullfrog mucus has viscoelastic properties similar to normal mammalian respiratory mucus and leopard frog mucus has viscoelasticity similar to sputum samples. MTR was significantly slower in the winter than in the summer months (17 vs. 30 mm/min; P less than 0.0001). Although the leopard frog palate could be used for at least 7 consecutive days without exhaustion, bullfrog palates could be used for only 5 days. Palates of either species could generally be tested for 6 h/day without a significant decrease in MTR. These data clarify some of the sources of variability in the use of this system and suggest methods of standardization.

Gemifloxacin versus Amoxicillin/Clavulanate in the Treatment of Acute Exacerbations of Chronic Bronchitis

2000 ◽  
Vol 12 (4) ◽  
pp. 314-325 ◽  
Author(s):  
T. File ◽  
B. Schlemmer ◽  
J. Garau ◽  
H. Lode ◽  
S. Lynch ◽  
...  
Keyword(s):  
Chronic Bronchitis ◽  
Acute Exacerbations ◽  
Amoxicillin Clavulanate

scholarly journals Efficacy and Safety of Long-Term Low-Dose Clarithromycin in Patients With Refractory Chronic Sinusitis After Endoscopic Sinus Surgery: A Prospective Clinical Trial

2021 ◽  
pp. 014556132110320
Author(s):  
Han Chen ◽  
Bing Zhou ◽  
Qian Huang ◽  
Cheng Li ◽  
Yubin Wu ◽  
...  
Keyword(s):  
Oral Administration ◽  
Nasal Cavity ◽  
Endoscopic Sinus Surgery ◽  
Low Dose ◽  
Continuous Treatment ◽  
Sinus Surgery ◽  
Efficacy And Safety ◽  
Endoscopic Findings ◽  
Before And After

Objective: To observe the efficacy and safety of postoperative long-term low-dose oral administration of clarithromycin in patients with refractory chronic rhinosinusitis (RCRS), to explore the characteristics of postoperative microbiota in the nasal cavity in patients with RCRS, and to compare the differences and changes in microbiota in the nasal cavity before and after medication. Methods: This was a prospective, self-controlled study. Eighteen patients with RCRS who had persistent symptoms after endoscopic sinus surgery and standard therapy with normal immunoglobulin E and eosinophil level were included. Low dose (250 mg, once daily) clarithromycin was orally administrated for 12 weeks. Symptom severity and endoscopic findings were evaluated before, after 4 weeks, and 12 weeks of treatment, and nasal cavity microbiota was analyzed simultaneously. Results: A total of 18 patients with RCRS were enrolled and 17 patients completed the study. Four weeks after oral administration of clarithromycin, significant improvement was observed in subjective symptoms including nasal congestion, rhinorrhea, postnasal drip, and general discomfort, as well as endoscopic findings including general surgical cavity condition, rhinedema, and rhinorrhea ( P < .05). After continuous treatment to the 12th week, symptoms showed significant improvement compared with baseline, and endoscopic score showed significant improvement compared with both baseline and 4 weeks after treatment. Analysis of middle nasal meatus flora revealed a significant decrease of Streptococcus pneumoniae after 12 weeks of clarithromycin treatment ( P < .05), while the richness, composition, and diversity were similar before and after treatment. Patients enrolled experienced no adverse drug reaction or allergic reaction, nor clinical significant liver function impairment observed. Conclusion: Postoperative low-dose long-term oral administration of clarithromycin in patients with RCRS can improve the clinical symptoms and facilitate the mucosal epithelialization, with good tolerance and safety. The efficacy of clarithromycin in patients with RCRS may be related to its regulatory effect on nasal cavity microbiota.

A multifaceted stewardship intervention helps curb steroid overprescribing in hospitalized patients with acute exacerbations of COPD

2021 ◽  
Author(s):  
Jennifer L Cole ◽  
Sarah E Smith
Keyword(s):  
Length Of Stay ◽  
Intervention Strategy ◽  
Audit And Feedback ◽  
Face To Face ◽  
Duration Of Therapy ◽  
Significant Difference ◽  
Acute Exacerbations ◽  
Before And After ◽  
Quasi Experimental ◽  
Prospective Audit And Feedback

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Corticosteroid overprescribing is well documented in real-world practice. There is currently no evidence to guide best practices for steroid stewardship. The aim of this study was to assess the effects of a 3-part stewardship intervention strategy on inpatient steroid prescribing in patients with acute exacerbations of COPD (AECOPD). Summary Investigators implemented a 3-part stewardship initiative consisting of (1) an anonymous survey for providers on steroid prescribing in a simplified case of AECOPD, (2) face-to-face education and review of survey results, and (3) prospective audit and feedback from a clinical pharmacist. This was a quasi-experimental before-and-after study evaluating hospitalized adults diagnosed with AECOPD in two 12-month study periods before (April 2019-March 2020) and after (May 2020-April 2021) implementation. The primary outcome was mean inpatient steroid dosing. Secondary outcomes were duration of therapy, length of stay (LOS), 30-day readmissions, 30-day mortality, and incidence of hyperglycemia. Per power analysis, there were 27 patients per cohort. The interventions resulted in a significant reduction in prednisone equivalents during hospitalization: 118 mg vs 53 mg (P = 0.0003). This decrease was similar in ICU (160 mg vs 61 mg, P = 0.008) and non-ICU (102 mg vs 49 mg, P = 0.004) locations. There was no significant difference in duration of therapy (8 days vs 7 days, P = 0.44), length of stay (3.3 days vs 3.9 days, P = 0.21), 30-day mortality (4% vs 7%, P = 0.55), 30-day readmissions (15% vs 7%, P = 0.39), or rate of hyperglycemia (48% vs 44%, P = 0.78). Conclusion A multifaceted stewardship intervention significantly reduced steroid dosing in hospitalized AECOPD patients. This reduction was not associated with known deleterious effects.

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