Results

Baseline patient characteristics are summarized in Table 1, The time elapsing between the tick bite and the appearance of EM was 3 days to 4 months, 17 days on average. Seasonal appearance of and erythema migrans is shown in Fig. 1. The geographic region was identical for patients presenting with either of the findings. Clinical response to azithromycin treatment is presented in Table 2. Fourteen days after treatment, fatigue, malaise, and periodic headaches were present in seven patients, and...

Single Dose Azithromycin in the Treatment of Genital Chlamydial Infections

Chmurny Comenius University Bratislava, Slovak Republic Pliva-Bratislava Bratislava, Slovak Republic Chlamydial infection is the most frequently encountered sexually transmitted disease and causes serious sequelae. Azithromycin is an azalide antibiotic with a very low minimal inhibitory concentration (MIC) for Chlamydia trachomatis and achieves high intracellular concentration which may be beneficial in eradicating this obligate intracellular pathogen....

Haemophilus influenzae Enterococci and Anaerobes

Yale University School of Medicine New Haven, Connecticut United Medical and Dental Schools of Guy's and St. Thomas's Hospitals London, United Kingdom The difficulties of in vitro susceptibility testing in relation to the MAS group of antibiotics in general, and this otherwise heterogeneous group of microorganisms in particular, were repeatedly stressed throughout the session. Wide discrepancies in results obtained by any of the conventional susceptibility-testing methods may be related to...

Discussion

Almost all of the tested macrolides had similar activities against the staphylococci except for a slight predominance of clarithromycin (for both) and josamycin (for the coagulase-negative staphylococci) (see Table 1). Clarithromycin and josamycin were more active than the other drugs against enterococci 29 and 25 of susceptible strains at 8 pgjm , respectively. Azithromycin and roxithromycin were the most active against Campylobacter sp. 90 of the strains inhibited at s 0.5 p m for...

Theophylline Table

The first clinical report of theophylline-erythromycin interaction appeared in 1977. In this report, the blood levels of theophylline increased 37 and 46 after the addition of 4.5-5.0 mg kg q6h of erythromycin A in two children. In healthy volunteers, after a 10-day course of erythromycin stearate (250 mg tid orally), the half-life of serum theophylline increased from 4.79 to 7.53 h, whereas drug clearance decreased from 91.6 to 54.8 ml h kg. Theophylline metabolites 3-methylxanthine and 1.3...

Drug Interactions of Macrolides and Azalides

Sheba Medical Center Tel-Aviv University, School of Medicine Tel-Hashomer, Israel The macrolides and azalides are antibiotics in common use in a large number of patients. Due to the fact that these antibiotics are frequently prescribed to patients with respiratory tract infections who receive many other agents such as bronchodilatators, mucolytic agents, cardiac medications, diuretics, and so forth, drug interactions of this group of agents are of particular importance. In addition, at the...

Legionella and Spirochetes

University Hospital Utrecht, The Netherlands Baylor College of Medicine and Veterans' Affairs Medical Center Houston, Texas Depending on the season and location, about 2-10 of community-acquired pneumonias (CAPs) are caused by Legionella spp. Most cases of Legionnaires' disease are caused by Legionella pneumophila, although infections by other species are well documented, Legionella spp. belong to the group of supposedly atypical organisms, together with Chlamydia pneumoniae, Coxiella burnetii,...

Conclusion On Streptococcus Pneumoniae

H. influenzae is pharmacologically resistant to erythromycin, poorly susceptible to roxithromycin (resistant to the concentrations obtained in vivo), whereas it is pharmacologically more susceptible to clarithromycin (susceptible to the concentrations obtained in vivo) and both pharmacologically and micro biologically more susceptible to azithromycin. There are major pitfalls associated with in vitro testing but they can be overcome. The E-test is an interesting alternative to the agar dilution...

Acknowledgments

I thank K, Pepper for helpful comments, and J.F. Desnottes and N. Ber-thaud for providing new data from their laboratory. 1. Barriere JC, Bouanchaud DH, Desnottes JF, Paris JM. Streptogramin analogues. Exp Opin Invest Drugs 1994 3(2) 115-131. 2. Aumercier M, Bouhallab S, Capmau ML, Le Goffic F RP 59500 a proposed mechanism for its bactericidal activity. J Antimicrob Chemother 1992 30 (suppl A) 9-14, 3- Cocito C, Di Giambattista M, Vannufel P. The mechanism of action of streptogramins. 3rd...

Could Clarithromycin Prevent Asthma

Kundsin, and Sharon A. Poulin Brig ham and Women's Hospital, The Children's Hospital Medical Center and Harvard Medical School Boston, Massachusetts Asthma is the most disabling of all chronic diseases in childhood, and one of the commonest. About 30 of individuals who are subsequently diagnosed, in middle childhood or later, as having asthma began with symptoms of recurrent wheezing, cough, and bronchospasm in the first year of life, A longitudinal study of infants...

Hi Mycoplasma Chlamydia

A Comparison of the In Vitro Sensitivity of Chlamydia pneumoniae to M aero Ii des and a New Benzoxazinorifamycin, KRM-1648 C.-C. Kuo, J. Thomas Grays ton, T. Hidaka, and L. M, Rose Susceptibilities to Azithromycin of Isolates of Chlamydia pneumoniae from Patients with Community-Acquired Pneumonia P. M. Roblin, N. Sokolovskaya, and M. R. Hammerschlag Azithromycin in Control of Trachoma Julius Schachter Microbiologic Efficacy of Azithromycin for the Treatment of Community-Acquired Pneumonia Due...

Staphylococci Streptococci and Pneumococci

Fondation H pital Saint-Joseph Paris, France University of Lisbon Lisbon, Portugal The authors of abstracts and discussants developed an overview of S. aureus, S. pneumoniae, and S. pyogenes reporting on susceptibility and susceptibility testing epidemiology of resistant strains and insights on therapy of infections. The susceptibility and susceptibility testing of S. aureus to the macro-lides and macrolide-related antibiotics should be considered regarding the different classes of compounds...

The Mechanism Of Action Of Type B Streptogramins

Cell Free Nirenberg And Matthaei

Unlike type A components, type B components are ineffective in the Nirenberg system 18 . This observation has prompted the development of other cell-free systems with copolymers as messengers. In these models, polypeptides with diverging properties are synthesized charged and hydro-philic, those primed by adenine polymers and neutral and hydrophobic, those directed by uracil-containing messengers. Indeed, the system containing poly A, C copolymers as templates are highly sensitive to inhibition...

MICs of Macrolides on H pylori

Pylori Mutation

When MICs were determined on strains of H. pylori, a small group of resistant strains was identified e.g., 10 in France 14 . The MICs of susceptible strains to clarithromycin at neutral pH range from 0.015 to 0.06 mg L. This compound is the most effective macrolide with a MIC of 0.03 mg L i.e., almost as low as amoxicillin . Other macrolides with good activity are azithromycin and roxithromycin 15 . When MICs are determined at a lower pH, their values increase, but, again, clarithromycin is the...

Macrolides As Antiinflammatory Agents In Vivo Studies

Low-dose, long-term erythromycin treatment has been reported effective in patients with chronic lower respiratory tract disease including diffuse pan-bronchiolitis 25-27 . Diffuse panbronchiolitis is characterized by chronic inflammation of the respiratory bronchioles and infiltration of chronic inflammatory cells, accompanied by repeated episodes of respiratory infections, especially due to Pseudomonas aeruginosa, which finally result in respiratory failure. The clinical effectiveness of...

Ketolides New Semisynthetic 14Membered Ring Macrolides

Macrolides Resistance Thylation

Andr Bryskier, Constantin Agouridas, and Jean-Fran ois Chantot Erythromycin A was discovered at a time when a new drug active against penicillinase-producing S. aureus strains was needed. Penicillinase-producing resistant strains appeared in London hospitals very shortly after the first clinical use of penicillin G, and soon spread worldwide 1 . This led to parallel research projects by the pharmaceutical industry and generated semisynthetic methicillin and isoxazolylpenicillins oxacillin,...