Tags: Roxithromycin

Isospora

Isospora infection is endemic in several tropical and subtropical climates in areas of South America, Africa, and southwest Asia. In the United States, Isospora belli infection occurs primarily in patients with AIDS but is still quite rare in this population, accounting for = 0.2% of AIDS-defining illnesses. Isospora infection is more common in patients with AIDS from developing countries in which the prevalence of spore passage is 15% compared with 5% in industrialized nations.

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Electrocardiographic changes, comprising altered T waves and prolongation of the QT interval, are not uncommon during high-dose treatment with chloroquine. The clinical significance of this is uncertain. With chronic intoxication, a varying degree of atrioventricular block can be seen; first-degree right bundle branch block and total atrioventricular block have been described.

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In 2917 adults, adverse effects of roxithromycin occurred in 4.1% at a dosage of 150 mg/day. Nausea (1.3%), abdominal pain (1.2%), and diarrhea (0.8%) were the most frequently reported events, whereas rash, vomiting, headache, dizziness, pruritus, urticaria, and constipation were reported only rarely. Treatment had to be withdrawn in 0.9% of the patients because of adverse effects. In an uncontrolled study in 24 HIV-infected patients, roxithromycin (300 mg bd for 4 weeks) was effective against cryptosporidial diarrhea.

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Intravenous clarithromycin caused thrombophlebitis in four patients when it was given inappropriately as a rapid bolus injection instead of a short infusion; the manufacturers have received other reports of similar reactions, even with infusions, but the incidence seems to be considerably lower than with erythromycin. In a prospective, non-randomized study, phlebitis occurred in 15 of 19 patients treated with intravenous erythromycin (incidence rate of 0.40 episodes/patient-day) and in 19 of 25 patients treated with intravenous clarithromycin (0.35 episodes/patient-day).

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Macrolides are a class of drugs that inhibit bacterial protein synthesis. They demonstrate excellent activity against atypical organisms (Mycoplasma, Chlamydia, and Legionella species), but have variable activity against typical pathogens (S. pneumoniae and H. influenzae). Macrolides are indicated for use in mild-to-moderate community-acquired pneumonia and are typically used as first- and second-line agents for this indication.

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The widespread use of tetracyclines has resulted in a steady increase in the prevalence of resistance to these agents. Therefore, empiric use of tetracycline is usually restricted to regions where resistance levels remain low or to cases where other appropriate antibiotics are contraindicated. Although some tetracyclines have very low activity against S. pneumoniae, doxycycline maintains good antipneumococcal activity and is the tetracycline most commonly used for treatment of bacterial community-acquired pneumonia.

Acute Exacerbations of Chronic Bronchitis: Current therapies

TABLE: Pharmacological Management of Underlying Disease During an Acute Exacerbation of Chronic Bronchitis summarizes the general pharmacological agents and classes used to manage acute exacerbations of chronic bronchitis. The primary therapies used in acute exacerbations of chronic bronchitis treat the causative infection (antibiotics), relieve symptoms (bronchodilators), and treat the underlying inflammation (corticosteroids). TABLE: Current Therapies Used for Acute Exacerbations of Chronic Bronchitis summarizes the leading antibiotic therapies used to treat the infection.

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Erythromycin is a macrolide antibacterial with a wide spectrum of activity, that has been used in the treatment of a wide range of infections caused by susceptible organisms.

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Azithromycin (Zithromax). Effects on the ears. Effects on fluid and electrolyte homoeostasis. Effects on the kidneys. Eosinophilia. Overdosage. Interactions. Antimicrobial Action.