scholarly journals Amoxicillin in the treatment of acute respiratory infections in children: a dialogue between a microbiologist and a clinical pharmacologist

2020 ◽  
Vol 65 (3) ◽  
pp. 169-176
Author(s):  
S. V. Sidorenko ◽  
I. A. Dronov
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Infections ◽  
Acute Otitis Media ◽  
Current Data ◽  
Acute Respiratory Infections ◽  
Significant Activity ◽  
Clinical Pharmacologist ◽  
Microbiological Methods ◽  
Tract Infections

The article presents a modern view of amoxicillin in the treatment of acute respiratory infections in children from point of view of a microbiologist and clinical pharmacologist. Modern microbiological methods have changed the idea of the microbiota of the respiratory tract, however, the etiology of acute bacterial infections of the respiratory tract has not undergone significant changes – Streptococcus pneumoniae and Haemophilus influenzae are still the most common pathogens. Amoxicillin remains the drug of choice for most respiratory infections of bacterial etiology. Inhibitor-protected aminopenicillins (amoxicillin/clavulanate etc.) do not have advantages over amoxicillin in most cases of acute respiratory tract infections, but increase the risk of adverse events. Current data on macrolides, which are widely used in clinical practice, indicate the need to limit their use in acute infections of the respiratory tract due to the increase in resistance of S. pneumoniae and the absence of clinically significant activity against H. influenza. Current information on the resistance of S. pneumoniae and H. influenzae, as well as available data on the pharmacokinetics of amoxicillin, require a review of dosing approaches. The daily dose of amoxicillin in children with acute respiratory infections should not be less than 45–60 mg/kg, and in many cases (acute otitis media, infections caused by H. influenzae or penicillin-resistant S. pneumoniae strains), more than 90 mg/kg/day is required. Amoxicillin has a wide therapeutic range, and therefore the use of high doses of the drug is not associated with a decrease in the safety of therapy.

scholarly journals Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

Bacterial Infections of the Adult Upper Respiratory Tract

2019 ◽  
Author(s):  
Laura K Certain ◽  
Miriam B Barshak
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Group A Streptococcus ◽  
The United States ◽  
Controlled Study ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Upper respiratory tract infections are the most common maladies experienced by humankind.1 The majority are caused by respiratory viruses. A Dutch case-controlled study of primary care patients with acute respiratory tract infections found that viruses accounted for 58% of cases; rhinovirus was the most common (24%), followed by influenza virus type A (11%) and corona­viruses (7%). Group A streptococcus (GAS) was responsible for 11%, and 3% of patients had mixed infections. Potential pathogens were detected in 30% of control patients who were free of acute respiratory symptoms; rhinovirus was the most common.2 Given the increasing problem of antibiotic resistance and the increasing awareness of the importance of a healthy microbiome, antibiotic use for upper respiratory infections should be reserved for those patients with clear indications for treatment. A recent study of adult outpatient visits in the United States found that respiratory complaints accounted for 150 antibiotic prescriptions per 1,000 population annually, yet the expected “appropriate” rate would be 45.3 In other words, most antibiotic prescriptions for these complaints are unnecessary. Similarly, a study in the United Kingdom found that general practitioners prescribed antibiotics to about half of all patients presenting with an upper respiratory infection, even though most of these infections are viral.4 This review contains 5 figures, 16 tables, and 82 references. Keywords: infection, airway, sinusitis, otitis media, otitis externa, pharyngitis, epiglottitis, abscess

scholarly journals Menginisiasi Perilaku Positif Masyarakat Tentang Penyakit ISPA di Desa Muntoi Timur Kabupaten Bolaang Mongondow

2020 ◽  
Vol 2 (1) ◽  
pp. 33-42
Author(s):  
Hamzah B
Keyword(s):  
Health Education ◽  
Respiratory Tract ◽  
Health Workers ◽  
Respiratory Infections ◽  
Wide Spectrum ◽  
Active Role ◽  
Public Knowledge ◽  
Acute Respiratory Infections ◽  
Implementation Phase ◽  
Tract Infections

Acute respiratory tract infections are diseases of the upper or lower respiratory tract, which can cause a wide spectrum of diseases ranging from asymptomatic or mild infections to deadly diseases. The high cases of acute respiratory infections in East Muntoi Village are caused by the arrival of the dry season which causes a lot of dust and hot weather as well as the lack of public knowledge about acute respiratory infections. The aim of this service is to increase the knowledge of the people of Muntoi Timur Village, Passi Barat District, Bolaang Mongondow Regency, about acute respiratory infections. This community service is carried out in Muntoi Timur Village, Passi Barat District with the target of hamlets 04 and 05. The methods used are phased from the planning (pre-test), the implementation phase (health education) and the evaluation stage (post-test). The results of this activity are increased public knowledge about the understanding, causes, risk factors, symptoms, prevention and management of acute respiratory infections. It is suggested that the active role of health workers be needed to always provide health education to the community related to acute respiratory infections, so that the community can improve their health independently.

scholarly journals Place of combination drugs in the therapy of acute bronchitis in children

2020 ◽  
pp. 42-47
Author(s):  
N. G. Kolosova ◽  
I. V. Grebeneva ◽  
V. D. Denisova ◽  
E. M. Maksimova
Keyword(s):  
Respiratory Tract ◽  
Respiratory Infections ◽  
Acute Bronchitis ◽  
Influenza Viruses ◽  
Human Bocavirus ◽  
Acute Respiratory Infections ◽  
Protective Function ◽  
Nonproductive Cough ◽  
Combination Drugs ◽  
Tract Infections

Acute respiratory tract infections accompanied by cough play a significant role in respiratory pathology in childhood. The incidence of acute respiratory infections among children is 4–5 times higher than among the adult population and accounts for more than 90% of all infectious and parasitic diseases registered in Russia. The highest rates of acute respiratory infections are observed among children of preschool age, especially in the first three years of life. As in adults, children’s cough, described as a symptom of «upper respiratory infection» or «acute bronchitis», is the most commonly diagnosed acute manifestation in primary care. These 2 diagnoses represent 75% of all cough cases. The most common etiological agents in acute bronchitis are respiratory viruses: adenovirus, influenza viruses and parainfluenza viruses, respiratory syncytial virus, rhinovirus, human Bocavirus, Coxsackievirus, herpes simplex virus, etc. Drug therapy for coughing is prescribed when there is a nonproductive cough that does not perform its protective function, meaning it does not contribute to the purification of the respiratory tract, and is aimed at dilution of sputum, reducing its adhesiveness (viscosity) and thus increase the effectiveness of coughing. The main groups of mucoactive drugs that are usually considered in this case are mucolytics, mucoregulators, mucokinetics, expectorants, and combination drugs. Combination drugs created to eliminate various elements of pathogenesis of respiratory diseases, accompanied by a nonproductive cough and bronchoobstruction, deserve close attention due to the possibility of using several active substances in fixed drug combinations with accurate dosages and proven clinical effectiveness, reducing the number of simultaneously taken drugs, reducing the risk of developing undesirable events. Oral administration of combined medicines becomes especially important in conditions when inhalation therapy is impossible.

scholarly journals Application of PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections

2021 ◽  
Author(s):  
Li Yang ◽  
Min Lanfang ◽  
Zhang Xin
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Objective There is a lack of studies comparing Procalcitonin (PCT), C-reactive protein (CRP) and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory infections. It is necessary to explore the correlation between above markers and different types of acute respiratory tract infections (ARTI). Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasma infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (P <0.05). The positive rate of combined detection of PCT, CRP and WBC was significantly higher than that of single detection. There was no significant difference of PCT, CRP and WBC levels between the group of Gram-positive (G+) bacteria infection and Gram-negative (G-) bacteria infection (P >0.05). ROC curve results showed that the area under the curve (AUC) of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be used as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

scholarly journals Analysis of antibiotic consumption for treating respiratory tract infections in children and compliance with the national clinical guidelines

2014 ◽  
Vol 67 (9-10) ◽  
pp. 282-289 ◽  
Author(s):  
Dragana Lakic ◽  
Ivana Tadic ◽  
Marina Odalovic ◽  
Ljiljana Tasic ◽  
Ana Sabo ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Acute Otitis Media ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Daily Dose ◽  
Tract Infections

Introduction. Respiratory infections are the most common infections in children. The aims of the study were to analyze the use of antibiotics for respiratory infections in the period 2008 - 2010 in children?s population in region of Nis and to estimate the rational use of antibiotics in relation to the recommendations of the National Guidelines for physicians in primary care. Material and methods. Data source was a Pharmacy Nis database. Antibiotics prescriptions were selected for the following diagnoses: H65-H75 (acute otitis media, mastoiditis), J01 (acute sinusitis), J02-J03 (tonsillopharyngitis), J12-J18 (community acquired pneumonia), J20 (acute bronchitis), J32 (chronic sinusitis), J42 (chronic bronchitis). Antibiotic consumption was expressed in defined daily dose/1000 inhabitants/day. Results. The most widely prescribed antibiotic for the treatment of upper respiratory tract infections in children during the three years was amoxicillin (34.63; 32.50 and 31.00 defined daily dose/1000 inhabitants/day in 2008, 2009 and 2010, respectively). In the treatment of infections of the middle ear and mastoid, the combination of amoxicillin and clavulanic acid, was the most prescribed antibiotics (60% of total consumption of antibiotics for this indication). Azithromycin was the most widely prescribed antibiotic for the treatment of lower respiratory tract infections in children during the observed period (6.92; 8.20 and 7.18 defined daily dose/1000 inhabitans/day in 2008, 2009 and 2010, respectively). Conclusion. Recommendations of national guidelines are not complied with the treatment of upper and lower respiratory infections in the children population in region of Nis. This could be a sign of potentially irrational use of antibiotics that need to be further examined. Education of physicians can influence irrational use of antibiotics.

scholarly journals Acute Respiratory Infections (ARI) and Weaning Status of Infants Admitted in Selected Hospitals of Rajshahi- A Case Control Study

2019 ◽  
Vol 32 (1) ◽  
pp. 70-81
Author(s):  
Farhana Yasmin ◽  
Md Jawadul Haque
Keyword(s):  
Infectious Diseases ◽  
Respiratory Tract ◽  
Breast Feeding ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Case Control ◽  
Case Group ◽  
Acute Respiratory Infections ◽  
Wide Range ◽  
Tract Infections

Background: Acute respiratory infections (ARI) include upper respiratory tract infections and lower respiratory tract infections. Infections of the respiratory tract are perhaps the most common human ailment. While they are a source of discomfort, disability and loss of time for most adults, they are a substantial cause of morbidity and mortality in young children. ARI may cause inflammation of the respiratory tract anywhere from nose to alveoli, with a wide range of combination of symptoms and signs. ARI in children is most common among others because heir constant contact with other kids who could be virus carriers. Children often don’t wash their hands regularly. They are also more likely to rub their eyes and put their fingers in their mouths, resulting in the spread of viruses. For prevention of malnutrition and infection of child breast feeding is an important determinant of child health in the prevention of malnutrition and infection but in many cultures other food was introduced years before the cessation of breast feeding. In Bangladesh, many infectious diseases such as diarrhoea and acute respiratory infections are the main cause of mortality and morbidity in infants aged less than one year. The importance of breast feeding in the prevention of infectious diseases during infancy is well known. Objective: In this study our main objective is to evaluate the association between ARI of infant and weaning status of infants admitted in selected Hospitals of Rajshahi. Study place and Method: This study provided a wide range of information regarding ARI and weaning status of infants admitted in selected hospitals of Rajshahi and from the surroundings. This was a case control type of study. A total of 230 caregiver or mothers were interviewed. Result & discussion: It was found that the relationship between weaning status of infants and occurrence of ARI was statistically significant (p<0.001). It was showed that majority of the babies of the case group were weaned by Cow’s milk and within the control group by mashed rice. The association between occurrence of ARI and type of weaning food was statistically significant (p<0.001). It was also found that majority of the babies living in rural areas developed ARI and also within the case group majority (29.6%) of the babies who were not exclusively breast fed developed ARI and the association between occurrence of ARI and EBF was statistically significant (p<0.001). Conclusion: Our study suggests that proportion of ARI is more among the infants who were weaned earlier. TAJ 2019; 32(1): 70-81

scholarly journals Antimicrobial Resistance in Haemophilus influenzae Respiratory Tract Isolates in Korea: Results of a Nationwide Acute Respiratory Infections Surveillance

2009 ◽  
Vol 54 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Songmee Bae ◽  
Jaehoon Lee ◽  
Jaehwa Lee ◽  
Eunah Kim ◽  
Sunhwa Lee ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Haemophilus Influenzae ◽  
Respiratory Infections ◽  
Resistance Mechanisms ◽  
Acute Respiratory Infections ◽  
Group Iii ◽  
Amoxicillin Clavulanate ◽  
Tract Infections ◽  
Multiple Amino Acid ◽  
First Time

ABSTRACT Antimicrobial susceptibility patterns and β-lactam resistance mechanisms of 544 Haemophilus influenzae isolates through the nationwide Acute Respiratory Infections Surveillance (ARIS) network in Korea during 2005 and 2006 were determined. Resistance to ampicillin was 58.5%, followed by resistance to cefuroxime (23.3%), clarithromycin (18.7%), cefaclor (17.0%), amoxicillin-clavulanate (10.4%), and chloramphenicol (8.1%). Levofloxacin and cefotaxime were the most active agents tested in this study. β-Lactamase production (52.4%) was the main mechanism of ampicillin resistance, affecting 96.1% of TEM-1-type β-lactamase. According to their β-lactam resistance mechanisms, all isolates were classified into the following groups: β-lactamase-negative, ampicillin-sensitive (BLNAS) strains (n = 224; 41.5%); β-lactamase-positive, ampicillin-resistant (BLPAR) strains (n = 255; 47.2%); β-lactamase-negative, ampicillin-resistant (BLNAR) strains (n = 33; 6.1%); and β-lactamase-positive, amoxicillin-clavulanate-resistant (BLPACR) strains (n = 28; 5.2%). Among the BLNAR and BLPACR strains, there were various patterns of multiple-amino-acid substitutions in penicillin-binding protein 3. Particularly, among BLNAR, group III isolates, which had three simultaneous substitutions (Met377Ile, Ser385Thr, and Leu389Phe), were identified for the first time in Korea. Three group III strains displayed the highest MIC of cefotaxime (1 to 2 μg/ml). The results indicate the importance of monitoring a changing situation pertaining to the increase and spread of BLNAR and BLPACR strains of H. influenzae for appropriate antibiotic therapy for patients with respiratory tract infections in Korea.

scholarly journals Probiotics for prevention of acute respiratory infections in children: therapeutic potential.

2021 ◽  
pp. 254-260
Author(s):  
Irina N. Zakharova ◽  
Narine G. Sugyan
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Therapeutic Potential ◽  
Respiratory Infections ◽  
Short Chain Fatty Acids ◽  
Acute Respiratory Infections ◽  
Human Respiratory Tract ◽  
Local Immunity ◽  
Respiratory Viral Infections

Acute respiratory viral infections represent a group of clinically, pathomorphologically similar acute inflammatory respiratory diseases that manifest by fever, a runny nose, sneezing, cough, sore throat, a general feeling of ill health of varying severity. Activation of latent, persistent infections of viral and/or bacterial origin may occur in recurrent respiratory infections. Decreased production of local immunity contributes greatly to the development of viral and bacterial infections, persistence of pathogenic micro-organisms. Intestinal microflora can directly or indirectly affect the human respiratory tract through increased production of cytokines, short-chain fatty acids. In recent years, there has been a scientific interest in the therapeutic potential of probiotics for the prevention of acute respiratory viral infections. Earlier studies have shown a positive effect of probiotics on the respiratory tract with a view to prevent and reduce the incidence and severity of respiratory infectious diseases by expending the number of IgA secreting cells in the bronchial mucosa. Studies showed that the use of probiotics can reduce the incidence of acute respiratory infections, duration of fever, cough, and the need for antibacterial agents in children. Peptidoglycans and muramyl peptides that are constituents of the bacterial cell wall have antiviral activity. Probiotics can also inhibit virus attachment through a process of competing for the specific receptors. The regeneration of the mucous membrane is enhanced by the ability of mucin to prevent the virus from attaching to epithelial cells and suppress virus replication. The antiviral effect of probiotics may be caused by the ability to produce antimicrobial peptides, dehydrogenases and NOs. Probiotics can modulate the functions of epithelial and dendritic cells, CD4 +, CD8 + T lymphocytes, NK cells, stimulate the synthesis of secretory immunoglobulins, helping to neutralize the virus.

scholarly journals Impact of parental smoking on influenza and others respiratory infections in children

2020 ◽  
pp. 475-482
Keyword(s):  
General Population ◽  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
University Hospital ◽  
Side Stream ◽  
Quitting Smoking ◽  
Observational Cohort ◽  
Tract Infections

BACKGROUND. The predisposition of cigarette smokers for the development of respiratory infections, including influenza, have been well documented. As well, those exposed to side stream smoke are prone to viral and bacterial infections of the respiratory tract. AIM. The study aimed to evaluate whether the prevalence of smoking parents is higher among children with respiratory tract infections, including influenza, in comparison to the general population. MATERIAL AND METHODS. Observational, cohort study. The authors surveyed a cohort of patients and their families, hospitalized in the Paediatric University Hospital in Warsaw during 2018 influenza season. Patients were diagnosed with influenza (using PCR) or other respiratory tract infections. A questionnaire on smoking habits was performed. RESULTS. Overall, 72 patients were included in the study, median age 2 years and 9 months (IQR: 1.4 – 7.2), influenza was diagnosed in 43% (n= 31) of patients. The percentage of regularly smoking parents in the whole cohort amounted to 33.3% (44 of 132) and was statistically significantly higher (p < 0.05) than in the general population (22.7%), whereas in the subgroup with influenza and non-influenza infections it reached 32.2% and 34.2%, respectively. CONCLUSIONS. The prevalence of smoking parents of children with acute respiratory tract infections is higher than in the general population: exposing children to tobacco smoke is one of the risk factors for acquiring influenza and others respiratory tract infections. Quitting smoking can decrease the risk of infectious diseases.

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