piperacillin--tazobactam-drug-combination and Dyspnea

Chronic obstructive pulmonary disease (COPD) is a common, chronic inflammatory disease of the airway, and acute exacerbation of COPD (AE-COPD) refers to the manifestations of inflammation in the lungs that appear within a short period of time. Some patients contract pneumonia, and they can be prone to recurrent attacks of AE-COPD combined with pneumonia. The efficacy of conventional treatments isn't generally satisfactory.. The study intended to investigate the effectiveness and safety of piperacillin tazobactam in combination with the use of high-frequency chest-wall oscillation (HFCWO) to produce expectoration for the treatment of pneumonia in patients with AE-COPD and to provide a reference for clinical treatment.. The research team designed a prospective, randomized controlled trial.. The study took place at the Sixth Hospital of Wuhan of the Affiliated Hospital of Jianghan University in Wuhan, China.. Participants were 92 patients who had been admitted to the hospital between January 2020 and November 2021 with AE-COPD combined with pneumonia.. Using the random number table method, the research team randomly assigned participants to one of two groups, an intervention group or a control group, each with 46 participants. The control group received conventional treatment with oxygen, antibiotics, antispasmodics, antiasthmatic drugs, and phlegmolytic drugs as well as HFCWO for sputum removal. In addition to those treatments, the intervention group received piperacillin tazobactam.. The research team measured the treatment's efficacy at one day postintervention. At baseline and at one day postintervention, the study also measured pulmonary function, laboratory indexes, and blood-gas-analysis indexes. In addition, the research team identified the time of disappearance of clinical symptoms, including the disappearance of cough, sputum, dyspnea, and pulmonary rales; calculated the length of hospital stay, and evaluated the treatment's safety.. Postintervention, the intervention group's clinical efficacy was significantly higher than that of the control group (P < .05), and the group's cough, coughing of sputum, dyspnea, disappearance time of pulmonary rales, and hospitalization times were all significantly lower than those in the control group (P < .05). The FEV1, FVC, FEV1% and FEV1/FVC levels were higher in both groups postintervention than at baseline and were significantly higher in the intervention group than in the control group (P < .05). Postintervention, the levels of IL-2, IL-10, TNF-α, CRP and PCT were lower in both groups than at baseline, and the intervention group's levels were significantly lower than those in the control group (P < .05). Postintervention, the PaCO2 level decreased and PaO2 and SaO2 levels increased in both groups compared to baseline; the intervention group's PaCO2 level was lower and PaO2 and SaO2 levels were higher than those in the control group. During the treatment, no adverse reactions occurred in the control group, and one participant had a decreased appetite in the intervention group; the incidence of adverse reactions in that group was 2.17% (1/46). That participant received no special treatment, and the condition improved after stopping the drug.. Piperacillin tazobactam combined with HFCWO for sputum evacuation can effectively treat patients with pneumonia in acute exacerbation of COPD, with high safety. The treatment is worthy of clinical application.

Topics: Chest Wall Oscillation; Cough; Dyspnea; Humans; Oxygen; Piperacillin, Tazobactam Drug Combination; Pneumonia; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Respiratory Sounds

Topics: Acute Kidney Injury; Aged; Agriculture; Anti-Bacterial Agents; California; Contrast Media; Cough; Diagnosis, Differential; Dyspnea; Fever; Granulomatosis with Polyangiitis; Humans; Lung Neoplasms; Male; Mexico; Piperacillin, Tazobactam Drug Combination; Pneumonia; Tomography, X-Ray Computed; Vancomycin

Topics: Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Biomarkers, Tumor; Dendritic Cell Sarcoma, Follicular; Dyspnea; Emergencies; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Firmicutes; Gram-Positive Bacterial Infections; Humans; Male; Mediastinal Neoplasms; Mediastinitis; Mouth; Piperacillin, Tazobactam Drug Combination; Tomography, X-Ray Computed

A broncholith is defined as the presence of calcified material within a bronchus or within a cavity communicating with a bronchus. It is most frequently caused by Histoplasmosis or tuberculosis (TB) spp. Bronchial distortion, irritation and erosion by broncholiths can cause bronchiectasis, recurrent pneumonias and haemoptysis. We present a case of recurrent pneumonia due to a broncholith, which resolved conservatively with antibiotics. Owing to recurrent fevers and post obstructive pneumonias, a lobectomy or rigid bronchoscopic removal were considered but the patient was deemed not to be a candidate for general anaesthesia due to her comorbidities. Broncholiths are an uncommon cause of bronchiectasis and recurrent pneumonias. However, the wide range of symptoms and low clinical suspicion are the main reasons why a diagnosis can be delayed. Various treatment options are available and the choice of therapy should be made depending on the broncholith's size, mobility, location and local surgical expertise.

Topics: Anti-Bacterial Agents; Bronchial Diseases; Bronchiectasis; Bronchoalveolar Lavage; Chest Pain; Dyspnea; Female; Fever; Humans; Lithiasis; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia; Recurrence; Treatment Outcome; Vancomycin

It is generally assumed that the lungs possess arterial autoregulation associated with bronchial obstruction. A patient with pneumonia and congestive heart failure unexpectedly developed frequent haemoptysis. High-resolution CT and diagnostic CT were performed as well as ventilation/perfusion (V/Q) scintigraphy with single-photon emission CT (SPECT)/CT. V/Q SPECT/CT demonstrated abolished ventilation due to obstruction of the left main bronchus and markedly reduced perfusion of the entire left lung, a condition that was completely reversed after removal of a blood clot. We present the first pictorially documented case of hypoxia-induced pulmonary vasoconstriction and flow shift in a main pulmonary artery due to a complete intrinsic obstruction of the ipsilateral main bronchus. The condition is reversible, contingent on being relieved within a few days.

Topics: Bronchoscopy; Cough; Down-Regulation; Dyspnea; Fever; Gentamicins; Humans; Hypertension, Pulmonary; Lung; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia; Pulmonary Embolism; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Ventilation-Perfusion Ratio