zithromax and Cough

With the growing number of COVID-19 cases in recent times. significant set of patients with extra pulmonary symptoms has been reported worldwide. Here we venture out to summarize the clinical profile, investigations, and radiological findings among patients with SARS-CoV-2-associated meningoencephalitis in the form of a systemic review. This review was carried out based on the existing PRISMA (Preferred Report for Systematic Review and Meta analyses) consensus statement. The data for this review was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase, and Cochrane library and Preprint servers up till 30 June 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes "SARS-COV-2," "COVID-19," and "meningoencephalitis." All peer reviewed, case-control, case report, pre print articles satisfying our inclusion criteria were involved in the study. Quantitative data was expressed in mean ± SD, while the qualitative date in percentages. Paired t test was used for analysing the data based on differences between mean and respective values with a p < 0.05 considered to be statistically significant. A total of 61 cases were included from 25 studies after screening from databases and preprint servers, out of which 54 of them had completed investigation profile and were included in the final analysis. Clinical, laboratory findings, neuroimaging abnormalities, and EEG findings were analyzed in detail. This present review summarizes the available evidences related to the occurrence of meningoencephalitis in COVID-19.

Topics: Adult; Aged; Antiviral Agents; Azithromycin; Confusion; Cough; COVID-19; COVID-19 Drug Treatment; Dyspnea; Electroencephalography; Fatigue; Female; Fever; Humans; Hydroxychloroquine; Male; Meningoencephalitis; Middle Aged; Neuroimaging; SARS-CoV-2

Opsoclonus-myoclonus-ataxia syndrome is a heterogeneous constellation of symptoms ranging from full combination of these three neurological findings to varying degrees of isolated individual sign. Since the emergence of coronavirus disease 2019 (COVID-19), neurological symptoms, syndromes, and complications associated with this multi-organ viral infection have been reported and the various aspects of neurological involvement are increasingly uncovered. As a neuro-inflammatory disorder, one would expect to observe opsoclonus-myoclonus syndrome after a prevalent viral infection in a pandemic scale, as it has been the case for many other neuro-inflammatory syndromes. We report seven cases of opsoclonus-myoclonus syndrome presumably parainfectious in nature and discuss their phenomenology, their possible pathophysiological relationship to COVID-19, and diagnostic and treatment strategy in each case. Finally, we review the relevant data in the literature regarding the opsoclonus-myoclonus syndrome and possible similar cases associated with COVID-19 and its diagnostic importance for clinicians in various fields of medicine encountering COVID-19 patients and its complications.

Topics: Adult; Anticonvulsants; Ataxia; Azithromycin; Clonazepam; Cough; COVID-19; COVID-19 Drug Treatment; Dyspnea; Female; Fever; Humans; Hydroxychloroquine; Levetiracetam; Male; Middle Aged; Myalgia; Opsoclonus-Myoclonus Syndrome; Oseltamivir; SARS-CoV-2; Valproic Acid

The aim of this study was to evaluate the efficacy and safety of azithromycin (AZI) combined with glucocorticoid (GC) in the treatment of children with refractory Mycoplasma pneumoniae.. Computer search for PubMed, EMbase, Cochrane Library, China Biomedical Literature Database (CBMdisc), China Knowledge Network (CNKI), Wanfang, VIP (VIP), and a randomized controlled trial (RCT) of AZI combined with GC in the treatment of children with refractory Mycoplasma pneumoniae pneumonia test (RCT), the search time limit is built until March 20, 2019. Two researchers independently performed literature screening, data extraction, and literature risk bias, and meta-analysis was performed using RevMan 5.3 software.. A total of 12 RCTs were included, including 1130 patients. Meta-analysis showed that AZI combined with GC therapy significantly improved the total effective rate of the disease compared with the conventional treatment group (odds ratio [OR] = 6.37; 95% confidence interval [CI] 4.03, 10.07; P < .00001; I = 0%), effectively shortened the antipyretic time (SMD = -2.29; 95% CI -2.70, -1.88; P < .0001); promoted lung inflammation absorption (SMD = -1.89; 95% CI -2.38, -1.40; P < .0001), reduced cough time (SMD = -2.39; 95% CI -2.80, -1.99; P < .0001); shortened hospital stay (SMD = -2.19; 95% CI -3.21, -1.17; P < .0001); improved imaging findings (OR = 5.38; 95% CI 1.09, 26.51, P = .04); reduced inflammation index (SMD = -3.15; 95% CI -4.93, -1.36; P = .004); improved immune function (SMD = 1.29; 95% CI -0.02, 2.60; P < .0001); had no significant adverse reactions (OR = 1.18; 95% CI 0.71, 1.98; P = .53).. According to the current limited research evidence, the addition of GCs to the conventional treatment of refractory Mycoplasma pneumoniae in children can improve the clinical efficacy to a certain extent, and the safety is better. However, due to the quality and quantity of the included literature, the conclusions of this study need to be confirmed by more high-quality studies.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Cough; Drug Therapy, Combination; Fever; Glucocorticoids; Humans; Length of Stay; Mycoplasma pneumoniae; Pneumonia, Mycoplasma

Systematic evaluation of the effectiveness and safety of Xiaoer Xiaoji Zhike Oral Liqud combined with azithromycin in the treatment of mycoplasma pneumonia in children. Clinical literatures were retrieved from PubMed, Cochrane Library, EMbase, VIP, CNKI, SinoMed, WanFang from inception to September 2019. Two reviewers independently screened out the literatures, extracted data and assessed the risk of bias of the included studies. Then, Meta-analysis was performed by RevMan 5.3 software. A total of 17 RCT were included, involving 1 712 patients. In this study, there were two subgroups by the application approach of azithromycin: oral azithromycin subgroup and intravenous azithromycin subgroup. According to Meta-analysis results, in terms of the alleviation of clinical symptoms and signs, such as shortening of antifebrile time, cough disappeared time, rales disappearance time, and lung X-ray infiltrating shadow disappearance time, Xiaoer Xiaoji Zhike Oral Liquid combined with oral azithromycin or intravenous azithromycin were better than single-dose azithromycin; in the aspect of the improvement of the overall effective rate, the two combination subgroups were better than the single-use azithromycin; In terms of the decline of IgM, the combination subgroups were also more efficient than the single-use azithromycin, with statistically significant differences. In terms of the incidence of adverse reactions, there was no significant difference between the two combination subgroups and the single-use azithromycin in children, and no serious adverse reactions were found. In inclusion, Xiaoer Xiaoji Zhike Oral Liquid combined with azithromycin can improve the clinical efficacy in treating pediatric mycoplasma pneumonia, with a high safety. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

Topics: Azithromycin; Child; Cough; Drugs, Chinese Herbal; Humans; Pneumonia, Mycoplasma

This paper reviews the most important clinical papers in cystic fibrosis published in 2018, having searched all the literature on Pubmed. Focus is on CFTR modulator therapy, randomised controlled trials, and infection/microbiology issues.

Topics: Administration, Inhalation; Aminophenols; Aminopyridines; Anti-Bacterial Agents; Azithromycin; Benzodioxoles; Bronchoalveolar Lavage; Bronchoalveolar Lavage Fluid; Chloride Channel Agonists; Cough; Cross Infection; Cystic Fibrosis; Disease Progression; Drug Combinations; Drug Therapy, Combination; Humans; Indoles; Lung Transplantation; Microbiological Techniques; Mycobacterium abscessus; Mycobacterium Infections, Nontuberculous; Nebulizers and Vaporizers; Proton Pump Inhibitors; Pseudomonas aeruginosa; Pseudomonas Infections; Pyrazoles; Pyridines; Pyrrolidines; Quinolones; Randomized Controlled Trials as Topic; Saline Solution, Hypertonic; Specimen Handling; Sputum; Treatment Outcome; Tuberculosis, Pulmonary

To systemically evaluate the safety and efficacy of Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children. PubMed, Wanfang Data, CNKI, VIP and CBM were used to search for the clinical randomized controlled trials on Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children from database establishment to July, 2017. The papers were screened according to the established inclusion and exclusion criteria, and then the quality of the included studies was evaluated to extract valid data for Meta-analysis by using Revman 5.3 software. A total of 31 clinical randomized controlled trials were included, involving 2 881 patients. Meta-analysis showed that as compared with azithromycin alone, the combination of azithromycin with azithromycin had obvious advantages in the total effective rate（OR=5.42,95%CI[3.98,7.38],

Topics: Azithromycin; Child; Cough; Drugs, Chinese Herbal; Fever; Humans; Injections; Pneumonia, Mycoplasma; Randomized Controlled Trials as Topic

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary condition, characterized by diffuse proliferation of neuroendocrine cells in the respiratory epithelium. DIPNECH lesions are less than 5 mm in size and are limited to the basement membrane with no invasion. There is limited information regarding epidemiology, natural history of disease progression, or the management of this rare entity. We present the experience of a center with extensive expertise in neuroendocrine disease.. A cohort of patients (N = 13) with DIPNECH treated and followed at our institution was identified. We describe the our approach to their care, our disease management and also provide a review of DIPNECH pathophysiology.. Our patient cohort consisted of twelve females and one male with a mean age of 63 years at the time of diagnosis. Dyspnea on exertion and dry cough were the most common presenting symptoms. Two patients were under surveillance without treatment; three patients were treated with a short-acting somatostatin analog; three patients were treated with azithromycin alone; four were treated with a combination of long-acting monthly somatostatin analogs and azithromycin; one patient received a combination of long-acting somatostatin analog and everolimus. Five patients had concomitant bronchial carcinoids.. DIPNECH is a rare pathology that can profoundly affect a patient's quality of life. Paroxysmal coughing episodes can be difficult to treat. Our limited single center experience shows encouraging response to use of somatostatin analogs, azithromycin, and everolimus in the management of debilitating DIPNECH associated symptoms.

Topics: Aged; Anti-Bacterial Agents; Antineoplastic Agents, Hormonal; Azithromycin; Bronchial Neoplasms; Carcinoid Tumor; Cough; Dyspnea; Everolimus; Female; Humans; Hyperplasia; Immunosuppressive Agents; Lung Diseases; Male; Middle Aged; Multiple Pulmonary Nodules; Neuroendocrine Cells; Octreotide; Pulmonary Disease, Chronic Obstructive; Pulmonary Fibrosis; Quality of Life; Respiratory Mucosa

To evaluate the therapeutic effects of antibacterial agents, glucocorticoid and intravenous immunoglobulin (IVIG) in treating Mycoplasma pneumoniae(MP) infections.. The literature was screened by the inclusion and exclusion criteria after searching at Cochrane Library, Pubmed, Wanfang, CNKI, and Weipu databases. According to JADAD evaluation system, the relevant information in each included report from the literature was evaluated. The evidence-based analysis was performed for the therapeutic effects of macrolides, glucocorticoid, and IVIG in treating MP infections. Meta-analysis was conducted on the suitable literature by RevMan 5.3 software supplied by Cochrane collaboration. Descriptive analysis was conducted on the literature unsuitable for meta-analysis.. (1) Seven foreign RCT reports and 7 domestic RCT reports were included in the analysis of the therapeutic effect of macrolides. There was a high heterogeneity among the 7 foreign reports. Five of these reports showed no significant difference in clinical effects between macrolides and non-macrolide antibacterial agents. The forest plot analysis of antipyretic timing and cough duration in the domestic literature with complete indicators suggested that for azithromycin sequential therapy vs. erythromycin intravenous therapy, the mean difference of antipyretic timing was-1.10 (95% CI: -1.60,-0.60) and the mean difference of cough duration was-1.56 (95% CI: -2.10,-1.03). (2) Three foreign RCT reports and 5 domestic RCT were included in the analysis of glucocorticoid therapy. The JADAD scores of all the reports were 1. The basic therapy drug was macrolides. The results of sub-group analysis suggested that for the patients who used glucocorticoid early vs. the patients who used non-glucocorticoid therapy, the mean difference of antipyretic time was-1.77(95% CI: -2.44,-1.10) and the mean difference of cough duration was-2.47 (95% CI: -2.86,-2.08); for the patients treated with glucocorticoid at 10 days after onset of diseases vs. the patients received non-glucocorticoid therapy, the mean difference of antipyretic time was-3.41 (95% CI: -4.10,-2.73) and the mean difference of cough duration was-2.25 (95%CI: -4.38,-0.12). (3) Regarding IVIG, all the included reports were case study or case report. Most of the literature focused on severe Mycoplasma pneumoniae infection and those with extrapulmonary complications. The limited results suggested a trend of the shortening of disease process and improvement of clinical symptoms by IVIG.. There was no exact evidence of the therapeutic effects of antibacterial agents in Mycoplasma pneumoniae infections. A trend of better therapeutic effect was inferred in macrolide antibiotics, especially azithromycin. The improvement of clinical symptoms was suggested with the usage of glucocorticoid as adjuvant therapy. IVIG as an adjuvant therapy is at an exploration stage.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Cough; Erythromycin; Glucocorticoids; Humans; Immunoglobulins, Intravenous; Macrolides; Mycoplasma Infections; Mycoplasma pneumoniae; Randomized Controlled Trials as Topic

Topics: Aged; Azithromycin; Cough; Cross-Over Studies; Double-Blind Method; Female; Humans; Idiopathic Pulmonary Fibrosis; Male; Quality of Life; Treatment Outcome

Cough variant asthma (CVA), as one of bronchitis diseases, features with repeated cough. In clinics, CAV does not show significant abnormal signs, therefore antibiotic therapy can hardly achieve satisfactory treatment effect. With the development of scientific technologies, the correlation between mycoplasma pneumoniae infection and CVA has become a hot research topic in clinics. In clinics, mycoplasma pneumoniae is extensively regarded as major cause for CVA, with complex pathogenic mechanism. The symptoms of CVA is characterized by chronic non abnormal inflammation, normally accompanied with bronchospasm and intestinal infection. Clinical practices show that about 6% of CVA children mainly show continuous cough till midnight during onset period, which is easily to misdiagnosed as bronchitis. Mycoplasma pneumoniae infection is a common disease threatening Children's health in China. With the annual increase of incidence of infantile pneumonia in China, mycoplasma pneumoniae infection has become a major reason leading to the death of child in China. More such mycoplasma pneumoniae infection is a sporadic disease spreading in a small range, and can onset in four seasons, making great impact on living quality and health of children. On this basis, this paper analyzes the correlation between Children's CVA and mycoplasma pneumoniae infection, in the hope of providing valuable reference for clinical treatment.

Topics: Adolescent; Asthma; Azithromycin; Child; Child, Preschool; China; Comorbidity; Cough; Erythromycin; Female; Humans; Immunoglobulin M; Incidence; Infant; Male; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Treatment Outcome

Bacteria and viruses are equally associated with the risk of acute episodes of asthma-like symptoms in young children, suggesting antibiotics as a potential treatment for such episodes. We aimed to assess the effect of azithromycin on the duration of respiratory episodes in young children with recurrent asthma-like symptoms, hypothesising that it reduces the duration of the symptomatic period.. In this randomised, double-blind, placebo-controlled trial, we recruited children aged 1-3 years, who were diagnosed with recurrent asthma-like symptoms from the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort; a birth cohort consisting of the general Danish population of Zealand, including Copenhagen. Exclusion criteria were macrolide allergy, heart, liver, neurological, and kidney disease, and, before each treatment, one or more clinical signs of pneumonia (respiratory frequency of ≥50 breaths per min; fever of ≥39°C; C-reactive protein concentration of ≥476·20 nmol/L [≥50 mg/L]). Each episode of asthma-like symptoms lasting at least 3 days was randomly allocated to a 3-day course of azithromycin oral solution of 10 mg/kg per day or placebo after thorough examination by a study physician at the Copenhagen Prospective Studies on Asthma research unit. Each episode was randomly allocated independently of previous treatment from a computer-generated list of random numbers in blocks of ten (generated at the Pharmacy of Glostrup). Investigators and children were masked until the youngest child turned 3 years of age and throughout the data validation and analysis phases. The primary outcome was duration of the respiratory episode after treatment, verified by prospective daily diaries and analysed with Poisson regression. Analyses were per protocol (excluding those without a primary outcome measure or who did not receive treatment). This trial is registered with ClinicalTrials.gov, number NCT01233297.. Between Nov 17, 2010, and Jan 28, 2014, we randomly allocated 158 asthma-like episodes in 72 children (79 [50%] to azithromycin and 79 [50%] to placebo). The mean duration of the episode after treatment was 3·4 days for children receiving azithromycin compared with 7·7 days for children receiving placebo. Azithromycin caused a significant shortening of the episode of 63·3% (95% CI 56·0-69·3; p<0·0001). The effect size increased with early initiation of treatment, showing a reduction in episode duration of 83% if treatment was initiated before day 6 of the episode compared with 36% if initiated on or after day 6 (p<0·0001). We noted no differences in clinical adverse events between the azithromycin (18 [23%] of 78 episodes included in final analysis) and placebo (24 [30%] of 79) groups (p=0·30), but we did not investigate bacterial resistance patterns after treatment.. Azithromycin reduced the duration of episodes of asthma-like symptoms in young children, suggesting that this drug could have a role in acute management of exacerbations. Further research is needed to disentangle the inflammatory versus antimicrobial aspects of this relation.. Lundbeck Foundation, Danish Ministry of Health, Danish Council for Strategic Research, Capital Region Research Foundation.

Topics: Adrenal Cortex Hormones; Adrenergic beta-2 Receptor Agonists; Anti-Bacterial Agents; Asthma; Azithromycin; C-Reactive Protein; Child, Preschool; Cough; Denmark; Double-Blind Method; Dyspnea; Early Medical Intervention; Female; Hospitalization; Humans; Infant; Male; Respiratory Sounds; Time Factors

Chronic cough is a common clinical problem worldwide. Although many patients have underlying precipitating conditions such as asthma, gastroesophageal reflux, or rhinitis, many remain symptomatic despite treating these conditions. New approaches are needed for the treatment of this group of patients.. We conducted a randomized, double-blind, placebo-controlled trial to determine whether 250 g of azithromycin three times a week for 8 weeks would affect the Leicester Cough Questionnaire (LCQ) score in 44 patients with treatment-resistant cough. Cough severity on a visual analog scale and bronchial exhaled nitric oxide were measured as secondary outcomes.. There was a clinically important improvement in LCQ score with azithromycin (mean change, 2.4; 95% CI, 0.5 to 4.2) but not placebo (mean change, 0.7; 95% CI, -0.6 to 1.9), but the between-group difference was not statistically significant (P = .12). There were no significant between-group differences for any of the secondary outcome measures. Looking at subgroups of responders, there was a large and significant improvement in LCQ score in patients with chronic cough and a concurrent diagnosis of asthma who were treated with azithromycin (mean, 6.19; 95% CI, 4.06 to 8.32).. Treatment with low-dose azithromycin for 8 weeks did not significantly improve LCQ score compared with placebo. The use of macrolides for treatment-resistant cough cannot be recommended from this study, but they may have a place in the treatment of chronic cough associated with asthma; this is worthy of further investigation.. WHO International Clinical Trials Registry; No.: ISRCTN75749391. URL: http://apps.who.int.

Topics: Aged; Anti-Bacterial Agents; Asthma; Azithromycin; Chronic Disease; Cough; Double-Blind Method; Female; Humans; Male; Middle Aged; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome

To explore the effect of Qingfei Huoxue Recipe (QHR) combined azithromycin in treatment of intractable pediatric mycoplasma pneumonia.. Totally 124 intractable pediatric mycoplasma pneumonia patients at our hospital were recruited in this study, and randomly assigned to the treatment group and the control group, 62 in each group. Patients in the control group took azithromycin, while those in the treatment group additionally took QHR. All patients received omnibearing systematic nursing. Therapeutic efficacy, clinical indices (such as disappearance time of cough and rales, recovery time of body temperature) , and the incidence of adverse reactions were observed.. After treatment the total effective rate was 91.94% (57/62 cases) in the treatment group and 77. 42% (48/62 cases) in the control group with statistical difference (P < 0.05). Compared with the control group, disappearance time of cough and rales, recovery time of body temperature were obviously shortened in the treatment group with statistical difference (P < 0.01). There was statistical difference in the incidence of adverse reactions between the two groups [3.23% (2/62 cases) vs 38.71% (24/62 cases) , P < 0.01].. In clinical treatment for intractable pediatric mycoplasma pneumonia, Chinese medicine combined Western medicine plus scientific and systematic nursing showed more obvious advantages with significant efficacy, which was worth spreading.

Topics: Azithromycin; Biomedical Research; Child; Cough; Drugs, Chinese Herbal; Humans; Medicine, East Asian Traditional; Phytotherapy; Pneumonia, Mycoplasma

Current definitions of pulmonary exacerbation (PE) in cystic fibrosis are based on studies in participants with significant lung disease and may not reflect the spectrum of findings observed in younger patients with early lung disease.. We used data from a recent trial assessing the efficacy of azithromycin in children to study signs and symptoms associated with PEs and related changes in lung function and weight.. While increased cough was present in all PEs, acute weight loss and reduction in oxygen saturation were not observed. Changes in lung function did not differ between subjects who did experience a PE and those who were exacerbation-free.. Cough was the predominant symptom in CF patients with early lung disease experiencing a PE. There was no significant difference in mean 6-month change in lung function or weight among subjects with one or more exacerbations and those without an exacerbation.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Cough; Cystic Fibrosis; Disease Progression; Double-Blind Method; Female; Humans; Lung; Lung Diseases; Male; Middle Aged; Respiratory Function Tests; Respiratory Tract Infections

Macrolides reduce exacerbations in patients with COPD. Their effects on health status has not been assessed as primary outcome and is less clear. This study assessed the effects of prophylactic azithromycin on cough-specific health status in COPD-patients with chronic productive cough.. In this randomised controlled trial 84 patients met the eligibility criteria: age of ≥40 years, COPD GOLD stage ≥2 and chronic productive cough. The intervention-group (n = 42) received azithromycin 250 mg 3 times a week and the control-group (n = 42) received a placebo. Primary outcome was cough-specific health status at 12 weeks, measured with the Leicester Cough Questionnaire (LCQ). Secondary outcomes included generic and COPD-specific health status and exacerbations. Changes in adverse events and microbiology were monitored.. Mean age of participants was 68 ± 10 years and mean FEV1 was 1.36 ± 0.47 L. The improvement in LCQ total score at 12 weeks was significantly greater with azithromycin (difference 1.3 ± 0.5, 95% CI 0.3;2.3, p = 0.01) and met the minimal clinically important difference. Similar results were found for the domain scores, and COPD-specific and generic health status questionnaires. Other secondary endpoints were non-significant. No imbalances in adverse events were found.. Prophylactic azithromycin improved cough-specific health status in COPD-patients with chronic productive cough to a clinically relevant degree.. ClinicalTrials.gov NCT01071161.

Topics: Aged; Anti-Bacterial Agents; Azithromycin; Chronic Disease; Comorbidity; Cough; Double-Blind Method; Female; Forced Expiratory Volume; Health Status; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Pulmonary Disease, Chronic Obstructive; Spirometry; Surveys and Questionnaires; Treatment Outcome

A validated instrument to assess the effects of chronic cough on health status in patients with chronic obstructive pulmonary disease (COPD) is currently not available. The Leicester Cough Questionnaire (LCQ) is a cough-specific health status questionnaire which is originally validated for a population of general patients presenting with chronic cough. We examined the psychometric performance of the LCQ in patients with COPD and chronic productive cough.. Concurrent validity, internal consistency, reproducibility and responsiveness were determined. The St. George's Respiratory Questionnaire (SGRQ) and the Short Form-36 (SF-36) were used as external criteria. Questionnaires were completed at the start of the study. After 2 and 12 weeks the LCQ was repeated, together with a global rating of change.. In total 54 patients were included. Concurrent validity analysis showed significant correlations between corresponding domains of the LCQ and the SGRQ (r(s) -0.31 to -0.60). Corresponding domains of the LCQ and the SF-36 showed weaker correlations (r(s) 0.04 to 0.41). Internal consistency was adequate for two of the three domains (Cronbach's α 0.74 - 0.86). Test-retest reliability in stable patients was high (intraclass correlation coefficients 0.79 - 0.93). The mean difference after two weeks was 0.73 (± 1.75). Responsiveness analysis indicated that the LCQ was able to detect changes after 12 weeks.. The LCQ is a valid, reliable, responsive instrument to measure health status in COPD patients with chronic productive cough.. ClinicalTrials.gov: NCT01071161.

Topics: Age Factors; Azithromycin; Chronic Disease; Cough; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Reproducibility of Results; Risk Factors; Sex Factors; Surveys and Questionnaires; Treatment Outcome

Azithromycin is recommended as therapy for cystic fibrosis (CF) patients with chronic Pseudomonas aeruginosa infection, but there has not been sufficient evidence to support the benefit of azithromycin in other patients with CF.. To determine if azithromycin treatment improves lung function and reduces pulmonary exacerbations in pediatric CF patients uninfected with P. aeruginosa.. A multicenter, randomized, double-blind placebo-controlled trial was conducted from February 2007 to July 2009 at 40 CF care centers in the United States and Canada. Of the 324 participants screened, 260 were randomized and received study drug. Eligibility criteria included age of 6 to 18 years, a forced expiratory volume in the first second of expiration (FEV(1)) of at least 50% predicted, and negative respiratory tract cultures for P. aeruginosa for at least 1 year. Randomization was stratified by age of 6 to 12 years vs 13 to 18 years and by CF center.. The active group (n = 131) received 250 mg (weight 18-35.9 kg) or 500 mg (weight > or = 36 kg) of azithromycin 3 days per week (Monday, Wednesday, and Friday) for 168 days. The placebo group (n = 129) received identically packaged placebo tablets on the same schedule.. The primary outcome was change in FEV(1). Exploratory outcomes included additional pulmonary function end points, pulmonary exacerbations, changes in weight and height, new use of antibiotics, and hospitalizations. Changes in microbiology and adverse events were monitored.. The mean (SD) age of participants was 10.7 (3.17) years. The mean (SD) FEV(1) at baseline and 168 days were 2.13 (0.85) L and 2.22 (0.86) L for the azithromycin group and 2.12 (0.85) L and 2.20 (0.88) L for the placebo group. The difference in the change in FEV(1) between the azithromycin and placebo groups was 0.02 L (95% confidence interval [CI], -0.05 to 0.08; P = .61). None of the exploratory pulmonary function end points were statistically significant. Pulmonary exacerbations occurred in 21% of the azithromycin group and 39% of the placebo group. Participants in the azithromycin group had a 50% reduction in exacerbations (95% CI, 31%-79%) and an increase in body weight of 0.58 kg (95% CI, 0.14-1.02) compared with placebo participants. There were no significant differences between groups in height, use of intravenous or inhaled antibiotics, or hospitalizations. Participants in the azithromycin group had no increased risk of adverse events, but had less cough (-23% treatment difference; 95% CI, -33% to -11%) and less productive cough (-11% treatment difference; 95% CI, -19% to -3%) compared with placebo participants.. In children and adolescents with CF uninfected with P. aeruginosa, treatment with azithromycin for 24 weeks did not result in improved pulmonary function.. clinicaltrials.gov Identifier: NCT00431964.

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Child; Cough; Cystic Fibrosis; Double-Blind Method; Female; Forced Expiratory Volume; Hospitalization; Humans; Lung; Male; Pseudomonas aeruginosa; Pseudomonas Infections

Although universal immunization against Bordetella pertussis (whooping cough) infection has resulted in dramatic reductions in the incidence of pertussis, outbreaks continue to occur in countries with excellent vaccine coverage. Treatment of infection may ameliorate symptom severity during the catarrhal phase of pertussis but has no effect on established paroxysms, emesis, or apnea if given during the paroxysmal or convalescent phases. Erythromycin, recommended for treatment of pertussis to prevent transmission of infection, is poorly tolerated because of gastrointestinal side effects. We compared the safety and efficacy of erythromycin with azithromycin for treatment of pertussis in a large, randomized, controlled trial that enrolled children from primary care practices in 1 American and 11 Canadian urban centers.. Children who were 6 months to 16 years of age and had cough illness that was suspected to be or was culture confirmed as pertussis were randomized to azithromycin (10 mg/kg on day 1 and 5 mg/kg on days 2-5 as a single dose) or erythromycin estolate (40 mg/kg/day in 3 divided doses for 10 days) with stratification by center. The primary outcome measure was bacteriologic cure of infection as determined by cultures of nasopharyngeal aspirates. Culture-positive participants had a second aspirate collected at the end of therapy (days 5-7 for azithromycin, days 10-12 for erythromycin) and 1 week after therapy. Bacteriologic cure was defined as negative cultures at the end of therapy. Bacteriologic relapse was defined as a positive culture 1 week after completion of therapy and after a negative end-of-therapy culture. Secondary outcomes were pertussis diagnosed by serology and polymerase chain reaction (PCR), treatment-associated adverse events, compliance, and presence of clinical symptoms at the end of the treatment course. Serology was performed using standard enzyme-linked immunosorbent assay methods. A participant was considered to have pertussis when the PCR was positive or a 4-fold increase in pertussis toxin antibody between baseline and follow-up visits was observed. PCR was performed using a 1046-bp ClaI DNA fragment from B pertussis. Adverse events (nausea, vomiting, diarrhea, any gastrointestinal complaint, or other) were determined by a parent-completed diary that was reviewed with study personnel during study visits. Compliance was measured by review of the parent medication diary during study visits and observation of medication containers by the pharmacist at study completion. Symptoms were determined by history collected by study personnel at enrollment and subsequently from the diary. The design of the study was an equivalence trial, aimed at demonstrating that the bacteriologic failure rates with the 2 therapies did not differ by >8%. For the safety analysis, all participants who received at least 1 dose of study drug were included. In the per-protocol efficacy analysis, all culture-positive participants with end-of-treatment cultures were considered.. A total of 477 children were enrolled and randomly assigned to either azithromycin (n = 239) or erythromycin (n = 238). Of these children, 114 (24%) grew B pertussis from nasopharyngeal specimens (azithromycin group: 58 of 239 [24%]; erythromycin group: 56 of 238 [23%]); these children composed the efficacy cohort for the per-protocol and intention-to-treat analyses. Serology and PCR added 52 children to the number considered to have pertussis for a total of 35% (166 of 477) of all children who presented with cough illness. In the safety analysis (antibiotic side effects, compliance) and comparison of cough symptoms after treatment, all randomized children are reported in their assigned treatment group. At end of therapy, bacterial eradication was demonstrated in all 53 patients in the azithromycin group and all 53 patients in the erythromycin group with follow-up cultures available (eradication 100%; 95% confidence interval [CI]: 93.3-100). No bacterial recurrence was demonstrated in children with 1 week posttreatment nasopharyngeal cultures available (51 and 53 participants in the azithromycin and erythromycin arms, respectively [0%, 95% CI: 0-7.0; and 0%, 95% CI: 0-6.7]). No serious adverse events attributable to study drug were observed. Gastrointestinal adverse events were reported less frequently in azithromycin (18.8%; 45 of 239) than in erythromycin estolate (41.2%; 98 of 238) recipients (90% CI on difference: -29.0% to -15.7%) as a result of less nausea (2.9% vs 8.4%; 95% CI: -8.9% to -2.0%), less vomiting (5.0% vs 13.0%; 95% CI: -4.9% to -1.4%), and less diarrhea (7.1% vs 11.8%; 95% CI: -9.0% to -0.3%). Children who were randomized to azithromycin were much more likely to have complied with antimicrobial therapy over the treatment period. In the azithromycin group, 90% of children took 100% of prescribed doses, whereas only 55% of children in the erythromycin group took 100% of prescribed doses.. In this large, multicenter, randomized trial, we found that azithromycin is as effective as erythromycin estolate for the treatment of pertussis in children. Gastrointestinal adverse events were much more common with erythromycin treatment than azithromycin. Compliance with therapy was markedly better with azithromycin than with erythromycin in this study.

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Bordetella pertussis; Child; Child, Preschool; Cough; Erythromycin Estolate; Female; Gastrointestinal Diseases; Humans; Infant; Male; Nasopharynx; Patient Compliance; Prevalence; Whooping Cough

Patient is a 77-year-old female who is a retired teacher living with her husband. Patient presents to the clinic for a post-hospital discharge visit. She was treated for bacterial pneumonia with combination therapy of azithromycin and cefpodoxime. She was diagnosed with COPD seven years ago when she had to be treated for chronic dyspnea, cough, and sputum that kept her breathless and required hospitalization.

Topics: Aged; Azithromycin; Cough; Dyspnea; Female; Humans; Pneumonia, Bacterial; Pulmonary Disease, Chronic Obstructive

Protracted bacterial bronchitis (PBB) causes chronic wet cough for which seasonal azithromycin is increasingly used to reduce exacerbations. We investigated the impact of seasonal azithromycin on antimicrobial resistance and the nasopharyngeal microbiome. In an observational cohort study, 50 children with PBB were enrolled over two consecutive winters; 25/50 at study entry were designated on clinical grounds to take azithromycin over the winter months and 25/50 were not. Serial nasopharyngeal swabs were collected during the study period (12-20 months) and cultured bacterial isolates were assessed for antimicrobial susceptibility. 16S rRNA-based sequencing was performed on a subset of samples. Irrespective of azithromycin usage, high levels of azithromycin resistance were found; 73% of bacteria from swabs in the azithromycin group vs. 69% in the comparison group. Resistance was predominantly driven by azithromycin-resistant

Topics: Anti-Bacterial Agents; Azithromycin; Bacteria; Bacterial Infections; Bronchitis, Chronic; Child; Chronic Disease; Cough; Drug Resistance, Bacterial; Erythromycin; Humans; Microbiota; RNA, Ribosomal, 16S; Seasons; Streptococcus pneumoniae

Low-dose long-term azithromycin is recommended in clinical practice guidelines for obstructive airway diseases (OAD); however, an optimal therapeutic regimen is not yet established.. To understand the patterns of azithromycin use in OAD, characterise the patients who received it and evaluate its safety and efficacy using real-world data.. We audited 91 patients who had received azithromycin for at least 4 weeks for the management of asthma, chronic obstructive pulmonary disease (COPD) or non-cystic fibrosis bronchiectasis.. The mean age was 65 ± 18 years, 60% were female and 48% were ex-smokers. The majority had asthma (75%), either alone (50%) or in combination with COPD (12%) or bronchiectasis (13%). Most (64%) reported cough or sputum at baseline. The most common treatment regimen was azithromycin 250 mg daily (73%) for more than 1 year (57%), with only seven adverse events. There was a significant reduction in the proportions of patients requiring emergency department visits (48% vs 32%; P < 0.001) and hospital admissions (35% vs 31%; P < 0.001) after starting azithromycin. In 88% of cases, physicians favoured the use of azithromycin.. Physicians are currently using low-dose azithromycin for a long duration of more than 1 year for the management of OAD. The typical case definition is an older non-smoking adult with persistent asthma, often in combination with another OAD and presenting with bothersome cough or sputum. Azithromycin was well tolerated and led to reduced healthcare utilisation. Further research is required to establish an optimal dosage regimen of azithromycin in OAD.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Asthma; Azithromycin; Bronchiectasis; Cough; Female; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive

There are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis.. In this case report, we present the case of a young pregnant Iranian woman who developed heart failure with pulmonary edema after cesarean section. She was treated because of low left ventricular ejection fraction and impression of postpartum cardiomyopathy, and her severe dyspnea improved by intravenous furosemide. On day 3, she exhibited no orthopnea or leg edema, but she was complaining of severe and dry cough. Further evaluation showed severe acute respiratory syndrome coronavirus-2 infection.. The possibility of severe acute respiratory syndrome coronavirus-2 infection should be considered in any pregnant woman who develops cardiomyopathy and pulmonary edema.

Topics: Adult; Anti-Bacterial Agents; Antiviral Agents; Azithromycin; Cardiomyopathies; Cesarean Section; Cough; COVID-19; Diagnosis, Differential; Diuretics; Dyspnea; Echocardiography; Electrocardiography; Female; Furosemide; Heart Failure; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Interferon-beta; Lung; Pre-Eclampsia; Pregnancy; Puerperal Disorders; Pulmonary Edema; SARS-CoV-2; Stroke Volume; Tomography, X-Ray Computed

The Coronavirus (COVID-19), (Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)) has been spreading worldwide since its first identification in China. It has been speculated that patients with comorbidities and elderly patients could be at high risk for the pandemic reasoned respiratory insufficiency and death. At first, it was thought that the patients who use immunmodulator therapy could be even at higher risks of disease complications. However, it has been also speculated about that using immunmodulators could be an advantage for the clinical prognosis. Therefore, several immunmodulators are currently being tested as potential treatment for COVID-19.. In this paper we report on a patient that has been treated with type 1 interferon for multiple sclerosis who developed COVID-19.. Despite using immunmodulator, the symptoms of the patient at hospitalization were mild and he did not show elevated D-dimer, and there was no lymphopenia. He was discharged to home-quarantine with no symptoms.. This report supports the idea of using type 1 interferon in the treatment could be effective in COVID-19 affected patients.

Topics: Adult; Anti-Bacterial Agents; Antimalarials; Azithromycin; Betacoronavirus; Coronavirus Infections; Cough; COVID-19; COVID-19 Drug Treatment; Humans; Hydroxychloroquine; Immunologic Factors; Interferon-beta; Length of Stay; Male; Multiple Sclerosis; Pandemics; Pneumonia, Viral; SARS-CoV-2; Severity of Illness Index; Tomography, X-Ray Computed

Topics: Adult; Aged; Aged, 80 and over; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Anti-Bacterial Agents; Antihypertensive Agents; Antiviral Agents; Azithromycin; Betacoronavirus; Coronavirus Infections; Cough; COVID-19; Female; Fever; Health Personnel; Humans; Hydroxychloroquine; Hypertension; Intensive Care Units; Lung; Male; Middle Aged; Myalgia; Oseltamivir; Oxygen Inhalation Therapy; Pandemics; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; Smoking; Tomography, X-Ray Computed; Travel; Turkey; Young Adult

Azithromycin is potential for preventing exacerbations in chronic respiratory diseases. However, rare attention was paid to the cough symptom of such airway diseases by azithromycin intervention. We summarized the efficacy and safety of azithromycin in chronic respiratory diseases related cough.. We searched 4 electronic databases (PubMed, EMBASE, Cochrane, and Web of Science) to identify randomized controlled trials (RCTs) comparing the change of Leicester Cough Questionnaire (LCQ) score, cough visual analogue scale (VAS) and side effects of azithromycin in patients of chronic respiratory diseases with cough.. We identified 5 RCTs (n=879 patients) in pooled analyses. Compared to placebo, azithromycin intervention had no effect in reducing cough [mean difference (MD) 0.73; 95% CI: -0.78 to 2.24; P=0.34] with significant heterogeneity (P=0.03, I2 =71%). However, heterogeneity is caused by one study. After removal of this study, azithromycin administration had shown clinically important improvement in LCQ score (MD 1.30; 95% CI: 1.15-1.46; P<0.00001; I2 =0%). In addition, no significant difference was detected in adverse events and azithromycin administration probably had less central nervous system side effects for chronic respiratory diseases with cough.. The addition of oral azithromycin may result in significant benefit for chronic respiratory diseases related cough. Azithromycin was safe for those patients with cough.

Topics: Azithromycin; Cough; Humans; Surveys and Questionnaires

Coronavirus disease 19 (COVID-19) is a viral pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease started as an epidemic in China in December 2019 that later achieved a pandemic potential spreading to over 210 countries with more than 3.5 million confirmed cases and close to 250,000 deaths till date. Its symptoms most commonly include, dry cough, fever, myalgia, and fatigue. As the number of new cases keeps on rising, many patients have been documented with gastrointestinal manifestations such as diarrhoea, vomiting and abdominal pain. We report a case of a 23-year-old female who presented with the primary complaint of diarrhoea, after positive contact history with a COVID-19 patient. Key Words: SARS-CoV-2, COVID-19, Pneumonia, ARDS, Diarrhoea.

Topics: Azithromycin; Betacoronavirus; Coronavirus; Coronavirus Infections; Cough; COVID-19; Diarrhea; Female; Fever; Humans; Hydroxychloroquine; Pandemics; Pneumonia, Viral; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Treatment Outcome; Young Adult

Coronavirus disease (COVID-19), first reported in December 2019 in Wuhan, China, has spread all over the world in a short time and was declared as a pandemic by the World Health Organization (WHO). During COVID-19 pandemic, chest computed tomography (CT) imaging has become an important tool with high sensitivity for diagnosis due to the low positive rate of the real-time reverse-transcriptase polymerase chain reaction (RT-PCR). Furthermore, the chest CT has played an important role in the diagnosis of underlying pulmonary lesions. In this case report, we present a patient who was admitted to the emergency department with fever, cough and left shoulder pain, and was subsequently diagnosed with both COVID-19 and pneumothorax following chest CT and RT-PCR test. Key Words: COVID-19, Coronavirus, Pneumothorax, Tomography.

Topics: Anti-Bacterial Agents; Anticoagulants; Antiviral Agents; Azithromycin; Betacoronavirus; Coronavirus; Coronavirus Infections; Cough; COVID-19; Enoxaparin; Female; Fever; Humans; Hydroxychloroquine; Lung; Male; Oseltamivir; Pandemics; Pneumonia, Viral; Pneumothorax; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Tomography, X-Ray Computed; Treatment Outcome; Young Adult

Topics: Administration, Cutaneous; Anti-Bacterial Agents; Azithromycin; Child, Preschool; Cough; Drug Tapering; Edema; Erythema Multiforme; Female; Fever; Glucocorticoids; Humans; Immunoglobulin M; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Prednisone; Pruritus

Acute fibrinous organising pneumonia is distinct from the classic diffuse alveolar damage, organising pneumonia and eosinophilic pneumonia. A 52-year-old woman presented with fever, productive cough, night sweats and left-sided pleuritic chest pain for a week. Physical examination was significant only for decreased breath sounds in the left infraclavicular area laterally. Imaging studies revealed a peripheral thick-walled left upper lobe cavitary lesion, left lower lobe consolidation and an enlarged subcarinal lymph node. She was treated with doxycycline for 10 days without improvement. Pertinent laboratory tests, microbiologic workup and fibre-optic bronchoscopy were non-diagnostic and a CT-guided left upper lobe lung biopsy revealed acute fibrinous organising pneumonia. She was treated with azithromycin with complete resolution of symptoms. To our knowledge, this is the first reported case of acute fibrinous organising pneumonia presenting as a cavitary lung lesion and the first with treatment response to azithromycin.

Topics: Anti-Bacterial Agents; Azithromycin; Bronchoscopy; Cough; Cryptogenic Organizing Pneumonia; Diagnosis, Differential; Female; Fever; Humans; Middle Aged; Tomography, X-Ray Computed

Topics: Anti-Bacterial Agents; Azithromycin; Bordetella pertussis; Cough; Drainage; Female; Humans; Infant; Pneumothorax; Radiography, Thoracic; Respiratory Insufficiency; Treatment Outcome; Whooping Cough

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Azithromycin; Cough; Erythema Multiforme; Fatigue; Female; Humans; Mycoplasma pneumoniae; Prednisone

Adult patients with chronic productive cough of unknown cause are commonly seen in respiratory clinics. We have previously described a subgroup of these patients who have a short-lived response to standard antibiotic treatment but a prolonged response to 3 months of low-dose azithromycin therapy.. This observational study describes the physiological, radiological and pathological features of this patient cohort along with their response to a 12-week open-label trial of 250 mg azithromycin thrice weekly.. A total of 30 subjects with a mean age of 57 were recruited. The majority demonstrated airway dilatation on high-resolution computed tomography (HRCT) scan without evidence of established bronchiectasis (n = 21) and non-specific chronic inflammatory changes on bronchial biopsy (n = 15/17). Twenty-nine subjects completed 3 months of azithromycin with a significant improvement in median Leicester Cough Questionnaire (LCQ) score (-6.3 points, P < 0.00001), reduction in median 24-h sputum volume (-5.8 mL, P = 0.0003) and improvement in sputum colour (P = 0.003). Patients responsive to azithromycin (n = 22) demonstrated neutrophilic or paucigranulocytic airway inflammation, whereas five subjects with eosinophilic airways inflammation did not respond symptomatically to azithromycin.. We describe a cohort of patients with chronic productive cough not adequately described by existing disease labels whose symptoms responded well to low-dose azithromycin. Many of the features are similar to the paediatric condition protracted bacterial bronchitis.

Topics: Anti-Bacterial Agents; Azithromycin; Chronic Disease; Cough; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Inflammation; Male; Middle Aged; Neutrophils; Sputum; Tomography, X-Ray Computed; Treatment Outcome

Topics: Anti-Bacterial Agents; Azithromycin; Cough; Humans; Macrolides

Topics: Anti-Bacterial Agents; Azithromycin; Bordetella pertussis; Cough; Female; Hospitalization; Humans; Infant; Whooping Cough

Topics: Administration, Oral; Anti-Bacterial Agents; Azithromycin; Child, Preschool; Conjunctivitis; Cough; Diagnosis, Differential; Fever; Humans; Male; Mucocutaneous Lymph Node Syndrome; Mucositis; Mycoplasma pneumoniae; Stevens-Johnson Syndrome

Pertussis is characterized by intense, prolonged coughing in children often followed by a distinctive whooping sound on inspiration. However, the clinical manifestations and natural course of pertussis in disabled children are largely unknown. We experienced a case of pertussis in a disabled girl who had previously undergone a tracheostomy and laryngotracheal separation. She presented with increased tracheal secretions and required hospitalization but did not develop a cough. Pertussis was suspected from the sputum Gram stain, which revealed numerous, short gram-negative rods that did not grow on chocolate agar. A nucleic acid amplification test was positive for Bordetella pertussis and the patient improved on azithromycin. Pertussis may present without its cardinal symptoms in disabled children.

Topics: Anti-Bacterial Agents; Azithromycin; Bordetella pertussis; Child; Cough; Diphtheria-Tetanus-acellular Pertussis Vaccines; Disabled Persons; Disease Transmission, Infectious; Female; Humans; Immunoglobulin G; Pertussis Toxin; Radiography; Sputum; Time Factors; Tracheostomy; Whooping Cough

Topics: Anti-Bacterial Agents; Azithromycin; Biomarkers; Community-Acquired Infections; Cough; Fatigue; Female; Humans; Middle Aged; Pneumonia, Bacterial

Psittacosis is a rare disease particularly in children with usual presentation of respiratory and constitutional symptoms. The cases may remain undiagnosed or diagnosis may be delayed because of lack of awareness among the paediatricians and physicians. Early diagnosis is very important as this is potentially curable and preventable disease. An interesting case of psittacosis is being reported here, which has been treated successfully with azithromycin.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Cough; Humans; Psittacosis; Radiography, Thoracic; Respiratory Insufficiency; Treatment Outcome

Topics: Adolescent; Antibiotic Prophylaxis; Azithromycin; Cough; Diagnosis, Differential; Diphtheria-Tetanus-acellular Pertussis Vaccines; Disease Outbreaks; Humans; Male; Pneumonia; Whooping Cough

Topics: Anti-Bacterial Agents; Azithromycin; Child; Cough; Disease Progression; Emergency Medical Technicians; Female; Humans; Infectious Disease Transmission, Patient-to-Professional; Oxygen Inhalation Therapy; Pertussis Vaccine; Severity of Illness Index; Unconsciousness; Vomiting; Whooping Cough

Topics: Afghanistan; Anti-Bacterial Agents; Azithromycin; Cough; Diagnosis, Differential; Exanthema; Female; Fever; Humans; Infant; Measles; Measles Vaccine; Morbillivirus; Pneumonia, Mycoplasma; Travel; Treatment Outcome; United States; Vaccination; Vitamin A; Vitamins

Topics: Azithromycin; Bronchial Diseases; Bronchoscopy; Calcinosis; Comorbidity; Cough; Female; Fever; Humans; Kartagener Syndrome; Macrolides; Middle Aged; Recurrence; Treatment Outcome

Plastic bronchitis (PB) is a rare cause of obstructive airway disease in patients who have undergone partially corrective surgery for congenital heart disease (CHD). The etiology of plastic bronchitis in such patients is ill-defined, and treatment is ineffective. We report resolution of PB and severe obstructive airway disease after heart transplantation in a patient with CHD.

Topics: Anti-Bacterial Agents; Azithromycin; Bronchitis; Child; Cough; Female; Fontan Procedure; Heart Defects, Congenital; Heart Transplantation; Humans; Respiratory Function Tests; Sputum; Treatment Outcome

Seven-week-old 32-week premature triplets were hospitalized because of rhinorrhea, cough with color change and posttussive emesis. One infant had a positive direct fluorescent antibody test for Bordetella pertussis, so all were treated with 5 days of azithromycin. Two of the infants were subsequently diagnosed with hypertrophic pyloric stenosis and underwent surgical pyloromyotomies 6 and 7 weeks, respectively, after the initial admission.

Topics: Anti-Bacterial Agents; Azithromycin; Bordetella pertussis; Cough; Cyanosis; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Pyloric Stenosis, Hypertrophic; Rhinitis; Triplets; Vomiting; Whooping Cough

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Bordetella pertussis; Contact Tracing; Cough; Diagnostic Errors; Female; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Professional-to-Patient; Pertussis Vaccine; Whooping Cough