trimethoprim--sulfamethoxazole-drug-combination and Respiratory-Tract-Diseases

The antimicrobial combination of trimethoprim and sulfamethoxazole is active in vitro against various gram-positive and gram-negative bacteria. Clinically, it is useful for prophylaxis and treatment of selected infections of the genitourinary, respiratory, and gastrointestinal tracts. Trimethoprim-sulfamethoxazole by itself or in combination with other antimicrobial agents is indicated for most Nocardia asteroides infections and is the antimicrobial agent of choice for Pneumocystis carinii pneumonia. The drug is relatively nontoxic in patients who do not have the acquired immunodeficiency syndrome (AIDS) and is available in both oral and intravenous forms. The native compounds and the metabolites of trimethoprim and sulfamethoxazole are excreted primarily in the urine. When the creatinine clearance is less than 30 ml/min, the dosage of trimethoprim-sulfamethoxazole should be adjusted.

Topics: Drug Resistance, Microbial; Female Urogenital Diseases; Gastrointestinal Diseases; Humans; Infections; Male Urogenital Diseases; Respiratory Tract Diseases; Trimethoprim, Sulfamethoxazole Drug Combination

Outbreaks ofPneumocystispneumonia have been described in renal transplant recipients. Aerosolized pentamidine is frequently used for prophylaxis in this setting. We report our experience with aerosolized pentamidine use in 56 renal transplant recipients. We found high rates of adverse reactions in patients with chronic respiratory disease.

Topics: Adult; Aerosols; Antifungal Agents; Bronchial Spasm; Female; Humans; Kidney Transplantation; Lung; Male; Pentamidine; Pneumocystis; Pneumonia, Pneumocystis; Renal Insufficiency, Chronic; Respiratory Tract Diseases; Transplant Recipients; Trimethoprim, Sulfamethoxazole Drug Combination

Among children infected with human immunodeficiency virus (HIV), respiratory diseases are a frequent cause of morbidity and mortality. This review describes respiratory manifestations of paediatric HIV infection before and after the beginning of HAART in Abidjan, Ivory Coast. In an observational cohort, HIV infected children had quarterly clinical visits and a day-clinic available all week for ill children. CD4 and viral load were measured at baseline and every 6 months thereafter. All children with a CD4 percentage below 25% were prescribed daily cotrimoxazole prophylaxis. Ninety-eight children (of a total of 282) were recruited before HAART and treated during the follow-up, there were 56 boys and 42 girls, with a mean age of 6.2 years at inclusion. The mean percentage of CD4 before HAART was 8.7%. Twelve children had a history of pulmonary tuberculosis and five were on antituberculosis treatment at inclusion. Fifty-one per cent presented with abnormalities on chest X-ray at inclusion. Before initiation of HAART, respiratory manifestations represented 32.4% of morbidity events and the incidence for 100 child/months was 9.29 for URTI, 15.2 for bronchitis, 6.07 for LRTI, 0.71 for tuberculosis and 0.36 for Pneumocystis carinii. After the initiation of HAART, respiratory manifestations represented 40.9% of all morbidity events and the incidence for 100 child/months was 5.35 for URTI, 9.48 for bronchitis, 2.17 for LRTI and 0.16 for tuberculosis. During HAART treatment, the incidence of respiratory infections decreased dramatically compared to before the antiretroviral treatment. However, respiratory events still represented 40% of all events occurring following the start of HAART therapy.

Topics: Anti-Infective Agents; Antiretroviral Therapy, Highly Active; Child, Preschool; Cote d'Ivoire; Female; HIV Infections; Humans; Male; Respiratory Tract Diseases; Retrospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination

Anaphylactic reactions to cotrimoxazole are often ascribed to the sulphamethoxazole component of this antibacterial drug.. To determine whether the trimethoprim component can be the cause of an anaphylactic reaction.. An analysis was made of reports on anaphylaxis attributed to trimethoprim, as notified to the Drug Safety Unit of the Dutch Inspectorate for Health Care.. In the period between September 1981 and November 1995, 13 such reports were received. Nine were classified as probable anaphylaxis. Of these, the causal relationship between exposure to trimethoprim and anaphylaxis was classified as definite in three reports, and as probable in the other six. The remaining four reports were classified as possible anaphylaxis. In one of these, the causal relationship was classified as definite, and in three as probable.. Although anaphylaxis due to trimethoprim seems to be rare, it may be more common than previously thought. Apparently, anaphylaxis to cotrimoxazole is not always caused by sulphamethoxazole.

Topics: Adult; Aged; Anaphylaxis; Anti-Infective Agents, Urinary; Antibodies, Anti-Idiotypic; Female; Gastrointestinal Diseases; Humans; Male; Middle Aged; Respiratory Tract Diseases; Skin Diseases; Time Factors; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

In this work the frequency of isolation of rods the genus Haemophilus from children suffering from various clinical sharpes of respiratory tract diseases. All isolated strains were tested in respect of species, biotype, the ability of adhesion to oral and laryngeal epithelia and their susceptibility to routinely applied antibiotics. A strong correlation between the species and biotype of rods from the genus Haemophilus and clinical shape of respiratory tract diseases was found. It was observed that the Haemophilus rods show differences in the ability of adhesion to oral and laryngeal epithelia. Only 52% of the isolated strains were susceptible to bactrim and 88% to tetracycline.

Topics: Anti-Bacterial Agents; Child; Child, Preschool; Female; Gram-Positive Rods; Haemophilus; Haemophilus influenzae; Humans; Infant; Male; Poland; Respiratory Tract Diseases; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination