Developments in Antibiotic Treatment of Respiratory Infections: Proceedings of the Round Table Conference on Developments in Antibiotic Treatment of Respiratory Infections in the Hospital and General Practice, held in the Kurhaus, Scheveningen, The Nether PDF
Preview Developments in Antibiotic Treatment of Respiratory Infections: Proceedings of the Round Table Conference on Developments in Antibiotic Treatment of Respiratory Infections in the Hospital and General Practice, held in the Kurhaus, Scheveningen, The Nether
DEVELOPMENTS IN ANTIBIOTIC TREATMENT OF RESPIRATORY INFECTIONS NEW PERSPECTIVES IN 4 CLINICAL MICROBIOLOGY SERIES EDITOR: W. BRUMFITT Other volumes in this series: 1. Brumfitt W, ed, Hamilton-Miller JMT, ass. ed: New perspectives in clinical microbi ology. 1978. ISBN 90-247-2074-5 2. Tyrrell DAJ, ed: Aspects of slow and persistent virus infections. 1979. ISBN 90-247- 2281-0 3. Brumfitt W, Curcio L, Silvestri L, eds: Combined antimicrobial therapy. 1979. ISBN 90-247-2280-2 Series ISBN 90-247-2329-9 DEVELOPMENTS IN ANTIBIOTIC TREATMENT OF RESPIRATORY INFECTIONS Proceedings of the Round Table Conference on Developments in Antibiotic Treatment of Respiratory Infections in the Hospital and General Practice, held in the Kurhaus, Scheveningen, The Netherlands, June 15-16, 1980 edited by RALPH VAN FURTH Department of Infectious Diseases University Hospital, Leiden The Netherlands 1981 MART INUS NIJHOFF PUBLISHERS THE HAGUE/BOSTON/LONDON The organization of this round table conference and the publication of the proceedings were made possible by the gratefully acknowledged financial support received from Abbott N.V., The Netherlands Distributors: for the United States and Canada Kluwer Boston, Inc. 190 Old Derby Street Hingham, MA 02043 USA for all other countries Kluwer Academic Publishers Group Distribution Center P.O. Box 322 3300 AH Dordrecht The Netherlands Library of Congress Cataloging in Publication Data Round Table Conference on Developments in Antibiotic Treatment of Respiratory Infections in the Hospital and General Practice (1980: Scheveningen, Netherlands) Developments in antibiotic treatment of respiratory infections. (New perspectives in clinical microbiology; 4) Includes index. 1. Respiratory organs - Infections - Chemotherapy - Congresses. 2. Antibiotics - Con gresses. I. Furth, Ralph van. II. Title. III. Series. RC735.A57R68 1980 616.2'00461 81-9533 ISBN -13 :978-94-009-8307-6 e-ISBN-13 :978-94-009-8305-2 AACR2 DOl: 10.1007/978-94-009-8305-2 Copyright © 1981 by Martinus Nijhoff Publishers, The Hague. So/tcover reprint 0/ the hardcover 1st edition 1981 All rights resaved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher, Martinus Nijhoff Publishers, P.O. Box 566,2501 CN The Hague, The Netherlands. CONTENTS List of contributors vii 1. Introduction The role of host defence in respiratory infections R. van Furth MICROBIOLOGY 2. The current antibiotic sensitivity of Haemophilus influenzae 9 J.C. Gould Discussion 15 3. Current pattern of antibiotic sensitivity of pneumococci 22 F.H. Kayser Discussion 27 4. Antibiotic sensitivity of Staphylococcus aureus. Past and present 33 R.P. Mouton Discussion 50 5. The colonization resistance of the digestive tract with special em- phasis on the oropharynx 53 D. van der Waaij Discussion 61 PHARMACOKINETICS 6. General review on pharmacokinetics of antimicrobial drugs in re- lation to respiratory infections 71 H.Mattie Discussion 78 7. Penetration ofmacrolides into the respiratory tract 79 F. Fraschini, M. Falchi and V. Copponi Discussion 84 8. Penetration of various antibiotics into sputum 86 C. Simon Discussion 95 VI 9. Penetration of various antibiotics into the middle ear 98 L. Sundberg and S. Ernstson Discussion 112 10. Penetration of various antibiotics into sinus cavities 116 O. Kalm Discussion 124 CLINICAL USE OF ANTIMICROBIAL AGENTS 11. Antibiotic treatment of sinusitis and otitis 131 P.B. van Cauwenberge Discussion 141 12. Antibiotic treatment of chronic bronchitis 146 R.l. Davies and G.K. Knowles Discussion 157 13. Treatment of respiratory infections in children 163 K.F. Kerrebijn Discussion 170 14. Antibiotic treatment of Mycoplasma pneumoniae infections 175 M. Van der Straeten Discussion 184 15. Developments in antibiotic treatment of respiratory infections ill general practice towards better prescribing 188 P.R. Grob Discussion 193 16. Antibiotic treatment during influenza virus infections 196 l.R. Dijkman Discussion 204 17. Antimicrobial treatment of Legionella pneumonia 208 P.L. Meenhorst Discussion 224 18. Pulmonary infections ill myelosuppressed or immunosuppressed patients 226 J.W.M. van der Meer Discussion 236 19. Prevention of respiratory infections by vaccination 238 R. van Furth Discussion 245 Subject index 249 LIST OF CONTRIBUTORS Cauwenberge van, P.B., Department of Otorhinolaryngology, Academisch Ziekenhuis, De Pintelaan 135, B-9000 Ghent, Belgium Davies, R.J., Academic Unit of Respiratory Medicine, St. Bartholomew's Hos pital, West Smithfield, London ECIA 7BE, England Dijkman, J.H., Department of Pulmonology, Academisch Ziekenhuis, Rijns burgerweg 10,2333 AA Leiden, The Netherlands Fraschini, F., Institute of Chemotherapy, Faculty of Medicine, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy Furth van, R., Department of Infectious Diseases, Academisch Ziekenhuis, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands Gould, J.C., Central Microbiological Laboratories, Western General Hospital, Grewe Road, Edinburgh EH4 2XU, Scotland Grob, P.R., Devonshire House, Station Road, Addlestone, Surrey KTl5 2AG, United Kingdom Kalm, 0., Department of Otorhinolaryngology, University Hospital, Fack, S-211 85 Lund, Sweden Kayser, F.H., Institute of Medical Microbiology, University of Zurich, Gloriastrasse 32, CH-8028 Zurich, Switzerland Kerrebijn, K.F., Department of Pulmonary Diseases, Sophia Kinderziekenhuis, Gordelweg 160, 3038 GE Rotterdam, The Netherlands Mattie, H., Department of Infectious Diseases, Academisch Ziekenhuis, Rijns burgerweg 10,2333 AA Leiden, The Netherlands Meenhorst, P.L., Department of Infectious Diseases, Academisch Ziekenhuis, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands Meer van der, J.W.M., Department of Infectious Diseases, Academisch Ziekenhuis, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands Mouton, R.P., Department of Medical Microbiology, Academisch Ziekenhuis, Rijnsburgerweg 10,2333 AA Leiden, The Netherlands Simon, C., Abteilung fUr Allgemeine Paediatrie, UniversiHits-KinderkIinik, Schwanenweg 20, 2300 Kiel 1, Germany Straeten Van der, M., Department ofInternal Medicine, Section Chest Diseases, Academisch Ziekenhuis, De Pintelaan 135, B-9000 Ghent, Belgium VIII Sundberg, L., Department of Otorhinolaryngology, Centrallasarettet, S-371 85 Karlskrona, Sweden Waaij van der, D., Laboratory for Medical Microbiology, Academisch Zieken huis, Oostersingel 59, 9713 EZ Groningen, The Netherlands 1. INTRODUCTION. THE ROLE OF HOST DEFENCE IN RESPIRATORY INFECTIONS R. VAN FURTH In healthy individuals there is an equilibrium between the host and the micro organisms in his environment, including those on the skin and mucous mem branes. An infection occurs when the interaction between the host and these micro-organisms is disturbed (Fig. I). This equilibrium can be disturbed because the host comes into contact with potentially pathogenic micro-organisms to which he has not yet been exposed and against which he does not yet have sufficient resistance, or because the number of potentially pathogenic micro organisms on the mucous membranes or in the air has increased, or because the INFECTION ~ '" HOST "" MICRO- -----....~... ORGANISM / THERAPY AND PREVENTION Fig. 1. Interaction between host and micro-organism. host's resistance has decreased. It must be kept in mind, however, that there is a difference between infection and contamination or colonization. An infection can be defined as a combination of reactions of the host to micro-organisms that have penetrated his body and multiply there. Here, the host plays an active role. Contamination or colonization concerns the presence ofliving micro-organisms on living tissue or dead material; thus, there is no reaction of the host to the (local) presence of micro-organisms. MICRO-ORGANISMS AND THE RESPIRATORY TRACT The respiratory tract is usually divided into the upper respiratory tract, which includes the nose, paranasal sinuses, middle ear, oral cavity, pharyngeal mucous 2 membranes, tonsils, epiglottis, and glottis, and the lower respiratory tract, which comprises the larynx, trachea, in bronchi, bronchioli, and alveoli. This dis tinction is useful, because under normal conditions the lower respiratory tract below the glottis is sterile, whereas the mouth, nose, and oral cavity are colonized by micro-organisms. If the mucous membranes of the lower respiratory tract have undergone pathological changes (e.g., in chronic bronchitis) or the com position of the mucus is abnormal (e.g., in mucoviscidosis) bacteria can be present on the mucous membranes without inducing inflammatory phenomena. Thus, colonization has occurred but not infection. This means that the presence of only micro-organisms in the sputum is not always an indication of infection, whereas when leukocytes are present as well, a (local) infection is probable if the clinical picture is consistent with this diagnosis. A wide variety of micro-organisms (viruses, bacteria, fungi, and protozoa) can colonize the upper respiratory tract and are potential pathogens. Micro organisms which can be involved in respiratory infections are listed in Table 1. Table 1. Micro-organisms involved in respiratory infections. Bacteria Viruses Streptococcus pneumoniae Adenovirus Haemophilus influenzae Streptococcus pyogenes Coxsackie virus Branhamella catarrhalis Echovirus Staphylococcus aureus Rhinovirus Legionella pneumophila Mycoplasma pneumoniae Corona virus Corynebacterium diphteriae Bordetella pertussis Influenza virus Para-influenza virus Klebsiella pneumoniae Respiratory-synocytial virus Escherichia coli Measles virus Proteus species Mumps virus Pseudomonas species Cytomegalo virus Mycobacterium tuberculosis Epstein-Barr virus Nocardia asteroides Herpes simplex virus Varicella-zoster virus Bacteroides species Fusobacterium species Reovirus Peptostreptococcus species Fungi Chlamydia psittaci Candida albicans Chlamydia trachomatis Aspergillus fumigatus Protozoa Pneumocystis carinii
The list of books you might like
