Role of oral extended-spectrum cephems in the treatment of acute exacerbation of chronic bronchitis

Prulifloxacin in the treatment of acute exacerbations of COPD in cigarette smokers

“…Previous studies have highlighted the possibility of dealing with AECOPD in smokers by using those cephalosporins that are particularly active on H. influenzae [Cazzola et al 1991;Brown, 1987]. However, emergence of antimicrobial resistance over the past two decades in common community-acquired respiratory tract pathogens [principally penicillin-and/or erythromycin-resistant S. pneumoniae (also multidrug-resistant strains) and -lactamase-producing H. influenzae and M. catarrhalis] has complicated empiric therapy approaches, requiring reliance on advancedgeneration oral agents including macrolides, cephalosporins, -lactam/-lactamase inhibitor combinations, and respiratory fluoroquinolones [Anzueto et al 2007;Mandell et al 2003]. In particular, the fluoroquinolone class of antimicrobial agents is being increasingly used empirically as resistance has developed to the more traditional antimicrobial agents [Patel and Wilson, 2006;Blasi et al 2003].…”

Trends in Antimicrobial Susceptibility of Streptococcus pneumoniae in the Tohoku District of Japan: A Longitudinal Analysis from 1998 to 2007

“…PK/PD breakpoints (µ g/ml) determined by serum concentrations present for 40 to 50% of the dosing interval for time-dependent agents such as β -lactams are reported to be 0.50-0.56 for CFDN, 0.36 for CFPN and 0.25-0.31 for CDTR. Based on the percentage of strains sensitive at PK/PD breakpoints, CDTR (58.5-66.7%) was relatively more active than CFDN (49.1-58.9%) and CFPN (41.5%) (Peric et al 2003;Nakamura and Takahashi 2004;Anzueto et al 2007). The percentages of our strains sensitive at PK/PD breakpoints for CFDN (0.50 µ g/ml), CFPN (0.36 µ g/ml) and CDTR (0.25 µ g/ml) were 37.0-64.1, 11.9-39.2 and 41.5-74.3%, respectively.…”

JAID/JSC Guidelines for the Treatment of Respiratory Infectious Diseases: The Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy – The JAID/JSC Guide to Clinical Management of Infectious Disease/Guideline-preparing Committee Respiratory Infectious Disease WG

“…---Drugs to be recommended--a. Empiric therapy Internationally, some studies have supported the usefulness of b-lactams [325,326]. However, in Japan, the resistance of S. pneumoniae and H. influenzae to macrolides and b-lactams is advanced, and P. aeruginosa is also sometimes isolated.…”