ro13-9904 and Asthma

In chronic persistent asthma and severe acute exacerbations of bronchial asthma, infectious agents are the predominant triggers that drive disease and airway pathobiology. In acute exacerbations of bronchial asthma (AEBA) including near fatal and fatal asthma, viral agents, particularly human rhinovirus-C, respiratory syncytial virus and influenza A appear to be the more prevalent and recurring threats. Both viral, and to a lesser extent bacterial agents, can play a role, and co-infection may also be present and worsen prognosis in hospitalized patients, placing a portion at risk for critical asthma syndrome. During severe acute exacerbations, infectious agents must be treated empirically, but the initial treatment regimens can vary and viral coverage may also vary based on seasonality and patient age. Early treatment with ceftriaxone and azithromycin, along with oseltamivir in winter months, should be initiated with all cases of severe exacerbations where infection is suspected, and definitely in critical asthma syndrome until infection is excluded by appropriate diagnostic testing. In this manuscript we will outline the impact of the major viral agents on severe asthma including the data from the 2009 H1N1 influenza pandemic. The role of bacterial infections in acute exacerbations of asthma will also be reviewed as well as the benefit of empiric antibiotics and the role of macrolides in both acute and chronic asthma.

Topics: Animals; Asthma; Azithromycin; Bacterial Infections; Ceftriaxone; Coinfection; Critical Illness; Disease Progression; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Oseltamivir; Seasons; Syndrome

In clinical practice, secondary infections of the central nervous system (CNS) represent rare yet severe complications of their respective primary infections. In this case report, we describe a 22-year-old patient with a medical history of Asthma bronchiale, who developed significant neurological deficits after a respiratory infection. The neurological symptoms progressed despite antibiotic therapy with vancomycin, ampicillin and ceftriaxone. The patient's cerebrospinal fluid and a cranial magnetic resonance imaging (MRI) furnished evidence of acute meningoencephalitis. Microbiological assessment confirmed an acute mycoplasma pneumonia infection. Changing the patient's antibiotic regimen to minocycline and prednisolone led to significant clinical improvement. Pathomechanisms and therapeutic options to treat meningoencephalitis will be discussed in the following.

Topics: Ampicillin; Anti-Bacterial Agents; Asthma; Ceftriaxone; Female; Humans; Magnetic Resonance Imaging; Meningoencephalitis; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Vancomycin; Young Adult

Topics: Aged; Asthma; Ceftriaxone; Cephalosporins; Drug Hypersensitivity; Female; Humans; Takotsubo Cardiomyopathy

Topics: Acute Disease; Administration, Inhalation; Adult; Asthma; Brain Abscess; Ceftriaxone; Cocaine-Related Disorders; Diagnosis, Differential; Drainage; Drug Therapy, Combination; Female; Headache; Humans; Magnetic Resonance Imaging; Meningitis, Escherichia coli; Nasal Septal Perforation; Photophobia; Pituitary Diseases; Pituitary Neoplasms; Vancomycin

A case of the toxic epidermal necrolysis in a 52-year-old woman treated for hypoxia of cerebral trunk during the severe attack of bronchial asthma and the bacterial infection of respiratory system was described. The pause of toxic epidermal necrolysis was treated with ceftriaxone and cefuroxime. The woman died on the 20th day of disease.

Topics: Asthma; Ceftriaxone; Cefuroxime; Cephalosporins; Drug Therapy, Combination; Fatal Outcome; Female; Humans; Immunoglobulin A; Middle Aged; Respiratory Tract Infections; Stevens-Johnson Syndrome