Clindamycin vs penicillin for anaerobic lung infections: high rate of penicillin failures associated with penicillin-resistant Bacteroides melaninogenicus

Article Abstract:

Anaerobic infections are caused by bacteria which either do not need oxygen, or live best in the absence of oxygen. Such infections in the lungs are responsible for anaerobic lung abscesses and necrotizing (cell-killing) pneumonia. Until recently, penicillin and clindamycin were thought to be equally effective in treating such infections, but clindamycin has lately been suggested to be more effective. The effectiveness of penicillin and clindamycin in treating such infections in 37 patients was evaluated. Bacteria responsible for infections were identified by sampling tissue or fluids from the lower respiratory tract. Initially, facultative (preferring oxygen but able to survive without it) bacteria from two patients were resistant to clindamycin, while one was resistant to penicillin. Ten strains of bacteria which were obligate anaerobes (i.e. can thrive only in the absence of oxygen) were found in 42 percent of all cases and were penicillin-resistant. None were clindamycin-resistant. Ten of 18 patients treated with penicillin and 18 of 19 patients treated with clindamycin responded well. Five of the patients who worsened had penicillin-resistant bacteria, while two others became infected with additional bacteria and the final two did poorly for other reasons. The study suggests that penicillin-resistant bacteria may be a common cause of failure of penicillin therapy of lung abscesses and necrotizing pneumonia. Clindamycin generally provides a good response, but research on the cost-effectiveness of such treatment is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Lungs, Lung, Anaerobic bacteria, Bronchi, Anaerobic infections, Clindamycin

---

Intermittent trimethoprim-sulfamethoxazole compared with dapsone-pyrimethamine for the simultaneous primary prophylaxis of Pneumocystis pneumonia and toxoplasmosis in patients infected with HIV

Article Abstract:

Two different drug treatments may be effective in preventing Pneumocystis (P.) carinii pneumonia and toxoplasmosis in HIV-infected patients. Of 200 HIV-infected people with CD4 counts less than 200, 96 took dapsone plus pyrimethamine orally twice weekly, and 104 took trimethoprim-sulfamethoxazole orally three times weekly. No patient taking trimethoprim-sulfamethoxazole contracted P. carinii pneumonia after 24 months of follow up, whereas 11% of patients taking dapsone-pyrimethamine contracted it by 24 months. However, in most of these cases, the patient had stopped taking the medication for two months before becoming ill. By 24 months after beginning treatment, 4% of those taking trimethoprim-sulfamethoxazole and 7% of those taking dapsone-pyrimethamine had contracted toxoplasmosis.

Prevention, Pneumocystis carinii pneumonia, Dapsone, Co-trimoxazole, Trimethoprim-sulfamethoxazole (Drug combination), Toxoplasmosis, Pyrimethamine

---

Resistance to penicillin and cephalosporin and mortality from severe pneumococcal pneumonia in Barcelona, Spain

Article Abstract:

Resistance of Streptococcus pneumoniae to penicillin and cephalosporin may not increase mortality in patients with severe pneumococcal pneumonia. Of 504 patients with pneumococcal pneumonia, 145 had infections resistant to penicillin and 31 had infections resistant to cephalosporin. During the 10-year study period, the mortality rate was 38% among patients with penicillin resistant infections, and 24% among patients with non-resistant infections. The mortality rate was 26% among patients with cephalosporin resistant infections, and 28% among patients with non-resistant infections. However, the difference in risk of death between patient groups became insignificant when an adjustment was made for other mortality risk factors.

Health aspects, Research, Drug resistance in microorganisms, Microbial drug resistance, Cephalosporins, Pneumonia, Pneumococcal, Pneumococcal pneumonia

Similar abstracts:

• Abstracts: Yersinia enterocolitica O:33 infections in infants and children, associated with the household preparation of chitterlings
• Abstracts: Antenatal microbiologic and maternal risk factors associated with prematurity. part 2 Chlamydia trachomatis infection during pregnancy
• Abstracts: Options for elective treatment of portal hypertension in cirrhotic patients in the transplantation era. Surgical procedures for bleeding esophagogastric varices when sclerotherapy fails: a prospective study
• Abstracts: An investigation of the cause of the eosinophilia-myalgia syndrome associated with tryptophan use. part 2 An outbreak of Escherichia coli O157:H7 colitis associated with consumption of precooked meat patties
• Abstracts: Impetigo: current etiology and comparison of penicillin, erythromycin, and cephalexin therapies. Comparison of amoxicillin and clavulanic acid (Augmentin) for the treatment of nonbullous impetigo

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.