sultamicillin and Lung-Abscess

Aspiration pneumonia (AP) and primary lung abscess (PLA), are diseases following aspiration of infectious material from the oropharynx or stomach. An antibiotic therapy, also covering anaerobic pathogens, is the treatment of choice. In this study we compared moxifloxacin (MXF) and ampicillin/sulbactam (AMP/SUL) concerning efficacy and safety in the treatment of AP and PLA.. Patients with pulmonary infections following aspiration were included in a prospective, open-label, randomized, multicenter trial. Sequential antibiotic therapy with MXF or AMP/SUL was administered until complete radiologic and clinical resolution.. A total of 139 patients with AP and PLA were included, 96 were evaluable for efficacy (EE, 48 patients in each treatment group). The overall clinical response rates in both groups were numerically identical (66.7%). MXF and AMP/SUL were both well tolerated, even after long-term administration [median duration of treatment (range) in days MXF versus AMP/SUL: AP 11 (4-45) vs 9 (3-25), PLA 30.5 (7-158) vs 35 (6-90)].. In the treatment of aspiration-associated pulmonary infections moxifloxacin appears to be clinically as effective and as safe as ampicillin/sulbactam; but, however, having the additional benefit of a more convenient (400 mg qd) treatment.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Aza Compounds; Female; Fluoroquinolones; Gram-Negative Bacterial Infections; Gram-Negative Facultatively Anaerobic Rods; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Lung Abscess; Male; Moxifloxacin; Pneumonia, Aspiration; Quinolines; Radiography; Sulbactam

Topics: Ampicillin; Anti-Bacterial Agents; Bronchial Fistula; Campylobacter Infections; Campylobacter rectus; Clindamycin; Diagnosis, Differential; Drainage; Empyema, Pleural; Fusobacterium Infections; Fusobacterium nucleatum; Humans; Lung Abscess; Male; Middle Aged; Pleural Diseases; Sulbactam; Thoracostomy

Topics: Ampicillin; Anti-Bacterial Agents; Bacteremia; Bronchiolitis, Viral; Drainage; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Lung Abscess; Male; Polymerase Chain Reaction; Respiratory Syncytial Virus Infections; Respiratory Syncytial Viruses; Streptococcal Infections; Streptococcus pyogenes; Sulbactam; Tomography, X-Ray Computed; Treatment Outcome

A 43-year-old woman had rheumatoid arthritis (RA) for 5 years and complained of fever, arthralgia/myalgia, and night sweating for a month. She had been receiving only leflunomide (20 mg/day) for 5 months. On admission, there was no evidence of active arthritis or vasculitic lesion. Laboratory evaluation showed an erythrocyte sedimentation rate of 145 mm/h and C-reactive protein of 160 mg/dl. All cultures were negative. Chest radiograph and computed tomography (CT) revealed a pulmonary abscess. Staphylococcus aureus multiplied in the culture of a purulent sample obtained from the abscess under ultrasonography. The leflunomide was stopped, and sultamicillin (IV 4x2 g/day) was started for a further 6 weeks. Four weeks later, the patient had completely recovered and CT showed significant improvement of the pulmonary abscess. Ten milligrams/day of prednisolone and 7.5 mg/week of methotrexate were started for RA treatment. The patient has been under control for 5 months without any further abscess or RA activation.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Antirheumatic Agents; Arthritis, Rheumatoid; Female; Humans; Isoxazoles; Leflunomide; Lung Abscess; Sulbactam; Tomography, X-Ray Computed

A 64-year-old woman with periodontal disease was admitted because of fever, right chest pain, and bloody sputum. Her chest radiograph revealed a nodular shadow in the right middle lung fields. From the results of a needle aspiration biopsy, she was diagnosed with a lung abscess due to Actinomyces odontolyticus (A. odontolyticus) and Streptococcus spp. The patient improved quickly with antibiotics. To our knowledge, only nine cases of pulmonary infection due to A. odontolyticus have been reported, and we report the first case in Japan. Although respiratory disease caused by A. odontolyticus is rare, the association of this organism should be considered even in healthy individuals.

Topics: Actinomyces; Actinomycosis; Ampicillin; Anti-Bacterial Agents; Biopsy, Needle; Female; Humans; Lung Abscess; Middle Aged; Streptococcal Infections; Sulbactam; Tomography, X-Ray Computed; Treatment Outcome