Management of acute and chronic respiratory tract infections

Abstract

Pharyngitis, bronchitis, and pneumonia represent the most common respiratory tract infections. With a view to establishing effective management strategies, the origins of these illnesses and the diagnostic techniques that have been developed to discover them are reviewed. Therapeutic regimens with documented efficacy are outlined with emphasis on specific rather than empiric treatment. Although many respiratory tract pathogens remain exquisitely sensitive to penicillin, the emergence of resistant strains underscores the need for safe and effective alternative therapies.

Sparfloxacin as alternative treatment to standard therapy for community-acquired bacteremic pneumococcal pneumonia

“…Since CAP can be such a serious disease, progressing rapidly if not treated immediately, and since Streptococcus pneumoniae is still an important and major pathogen [1], it is essential that the antibacterial agent given has good activity against the pneumococcus. Although penicillins have proved the mainstay of therapy against Streptococcus pneumoniae for decades, the increasing occurrence of strains with reduced susceptibility or resistance to penicillin worldwide [20] has compromised their value.…”

“…Community‐acquired respiratory tract infections (RTIs) are a major cause of morbidity worldwide, and most require empirical therapy, since they can be acute, of rapid onset, and serious [1]. Community‐acquired pneumonia (CAP) is the most serious of the respiratory infections, frequently requiring hospitalization and carrying a 5–15% mortality rate.…”

Acute bronchitis: Results of U.S. and European trials of antibiotic therapy

“…Patients with acute bronchitis generally have a persistent cough that is usually accompanied by sputum production and occasionally by fever, chest pain, or both. These symptoms develop quickly and are usually preceded by an upper respiratory tract infection [1][2][3][4][5]. Such factors as the age and general health of the patient, climate, exposure to air pollutants, and cigarette smoke contribute to the onset and severity of the illness [1,3,6].…”

“…The etiologic agents most likely to cause bronchitis vary with the age of the patient. Viral pathogens include respiratory syncytial virus, parainfluenza virus, rhinovirus, and influenza virus [3][4][5] as well as adenovirus [3,4], coronavirus [3,5], and rubeola virus [3]. The extent to which bacterial infection is implicated in the development of acute bronchitis is controversial, in part because it is difficult to obtain sputum samples that are not contaminated with bacteria normally present in the nasopharyngeal tracts of healthy persons.…”

“…Patients with acute bronchitis that is suspected to be of viral origin are often treated with acetaminophen [4] and cough suppressants [3] for symptomatic relief. When bacterial origin is either suspected or documented, antibiotics are routinely used for treatment [1,5]. Newer antibiotics are currently being tested to determine their efficacy against such illnesses as acute bronchitis.…”