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Clinical implications and treatment of multiresistant Streptococcus pneumoniae pneumonia.

Streptococcus pneumoniae is the leading bacterial cause of community-acquired respiratory tract infections. Prior to the 1970s this pathogen was uniformly susceptible to penicillin and most other antimicrobials. However, since the 1990s there has…

Tags: 2006, Anti-Infective Agents/*therapeutic use, Bacterial, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Community-Acquired Infections/*drug therapy/economics/*microbiology, Department of Internal Medicine, Drug Resistance, File T M Jr, Fluoroquinolones/*therapeutic use, Humans, Ketolides/therapeutic use, Multiple, NEOMED College of Medicine, Pneumococcal/*drug therapy/economics/*microbiology, Pneumonia, Streptococcus pneumoniae/*growth & development

Optimal treatment strategies for community-acquired pneumonia: non-responders to conventional regimens.

When patients with community-acquired pneumonia (CAP) fail to respond after initiation of empirical therapy, it is necessary for the physician to consider a number of possibilities. The diagnosis should be reviewed, with consideration given to both…

Tags: 2001, Anti-Infective Agents/therapeutic use, Chemotherapy, Community-Acquired Infections/drug therapy/microbiology/pathology, Department of Internal Medicine, Drug Resistance, Female, File T M Jr, Humans, Male, Microbial, NEOMED College of Medicine, Ofloxacin/therapeutic use, Pneumonia/*drug therapy/etiology/pathology, Practice Guidelines as Topic, Suppuration/drug therapy/pathology, Treatment Failure

Overview of resistance in the 1990s.

The tremendous therapeutic advantage afforded by antibiotics is being threatened by the emergence of increasingly resistant strains of microbes. Selective pressure favoring resistant strains arises from misuse and overuse of antimicrobials (notably…

Tags: *Drug Resistance, 1999, Anti-Bacterial Agents/*therapeutic use, Bacterial/*drug therapy, Chest, Community-Acquired Infections/drug therapy, Cross Infection/drug therapy, Department of Internal Medicine, File T M Jr, Humans, Multiple, NEOMED College of Medicine, Pneumonia

Preface.

Tags: 2013, Community-Acquired Infections – Prevention and Control, Department of Internal Medicine, File T M Jr, Infectious Disease Clinics, NEOMED College of Medicine, Pneumonia – Prevention and Control

New Diagnostic Tests for Pneumonia: What is Their Role in Clinical Practice?

The utility of diagnostic studies to determine the etiologic agents of community-acquired pneumonia has been controversial in part because of the lack of rapid, accurate, easily performed, and cost-effective methods. Advancements in molecular testing…

Clinical consulation. Gram stain and culture: recommendations for confirming pneumonia.

Tags: 2001, Department of Internal Medicine, File T M Jr, Journal of Respiratory Diseases, Microbiological Techniques, NEOMED College of Medicine, Pneumonia – Diagnosis, Sputum – Analysis

Community-acquired pneumonia: highlights of recent guidelines: how new recommendations may affect your practice.

The Infectious Diseases Society of America (IDSA) recently published updated guidelines for assessing and treating patients with community-acquired pneumonia. In contrast to the common practice of treating patients on the basis of clinical…

Tags: 1999, Community-Acquired Infections, Department of Internal Medicine, File T M Jr, Journal of Respiratory Diseases, NEOMED College of Medicine, Pneumonia, Pneumonia – Diagnosis, Risk Factors

Community-acquired pneumonia: recent guidelines for therapy.

The Infectious Diseases Society of America advocates using pathogen-directed therapy whenever possible to help reduce the emergence of drug resistance. Options for empiric therapy for outpatients include a macrolide, a new fluoroquinolone with…

Tags: 1999, Community-Acquired Infections – Drug Therapy, Community-Acquired Infections – Microbiology, Department of Internal Medicine, File T M Jr, Journal of Respiratory Diseases, NEOMED College of Medicine, Pneumonia – Drug Therapy, Pneumonia – Microbiology

Treating CAP caused by penicillin-resistant S pneumoniae.

Over the last decade, the incidence of penicillin resistance among Streptococcus pneumoniae isolates has markedly increased. This trend is unsettling because infections caused by S pneumoniae are among the leading causes of morbidity and mortality in…

Tags: 1999, Bacterial, Bacterial – Diagnosis, Community-Acquired Infections, Department of Internal Medicine, Diagnosis, Differential, Drug Resistance, File T M Jr, Journal of Respiratory Diseases, Microbial, NEOMED College of Medicine, Pneumonia, Streptococcal Infections

A new dosing paradigm: high-dose, short-course fluoroquinolone therapy for community-acquired pneumonia.

The goals of optimal antimicrobial therapy are to treat infection effectively, to improve the clinical condition of the patient, and to prevent the emergence of resistant bacterial strains. For ideal drug usage the World Health Organization…

Tags: 2003, Antiinfective Agents, Clinical cornerstone, Department of Internal Medicine, File T M Jr, Fluoroquinolone, Fluoroquinolone – Administration and Dosage, Fluoroquinolone – Economics, Fluoroquinolone – Pharmacodynamics, Fluoroquinolone – Therapeutic Use, NEOMED College of Medicine, Pneumonia – Drug Therapy

Community-acquired pneumonia.

The challenge of SARS: a clinical review.

Severe acute respiratory syndrome (SARS) is a newly described emerging infection caused by a novel coronavirus, which can be highly contagious by close contact. Patients may present with an acute febrile illness that involves the lower respiratory…

Tags: 2004, Department of Internal Medicine, File T M Jr, Infection Control, Journal of Respiratory Diseases, NEOMED College of Medicine, Severe Acute Respiratory Syndrome – Diagnosis, Severe Acute Respiratory Syndrome – Epidemiology, Severe Acute Respiratory Syndrome – Radiography, Severe Acute Respiratory Syndrome – Symptoms

Evolution of amoxicillin/clavulanate in the treatment of adults with acute bacterial rhinosinusitis and community-acquired pneumonia in response to antimicrobial-resistance patterns.

Current treatment guidelines for community-acquired respiratory tract infections no longer depend solely on the characteristics of the patient and the clinical syndrome, but on those of the offending pathogen, including presence and level of…

Tags: 2004, Antibiotics, Bacteria – Drug Effects, Benninger MS, Clinics in laboratory medicine, Combined – Therapeutic Use, Community-Acquired Infections – Drug Therapy, Community-Acquired Infections – Microbiology, Department of Internal Medicine, Drug Resistance, File T M Jr, Jacobs MR, Microbial, Microbial Culture and Sensitivity Tests, NEOMED College of Medicine, Pneumonia – Drug Therapy, Pneumonia – Microbiology, Rhinosinusitis – Drug Therapy, Rhinosinusitis – Microbiology

Guidelines for empiric antimicrobial prescribing in community-acquired pneumonia.

Empiric antimicrobial prescribing for community-acquired pneumonia remains a challenge, despite the availability of treatment guidelines. A number of key differences exist between North American and European guidelines, mainly in the outpatient…

Clinical implications of 750 mg, 5-day levofloxacin for the treatment of community-acquired pneumonia.

OBJECTIVE: To evaluate the time to symptom resolution and i.v.-to-p.o. transition in community-acquired pneumonia (CAP) patients treated with 750 mg or 500 mg levofloxacin. RESEARCH DESIGN: A retrospective, subset analysis of a multicenter,…

Clinical characteristics of Chlamydia pneumoniae infection as the sole cause of community-acquired pneumonia.

The clinical characteristics of 26 patients with community-acquired pneumonia due to Chlamydia pneumoniae as the only identified pathogen who required hospitalization were evaluated. Most patients (18) had reinfection based on serological results.…

A multicenter, randomized study comparing the efficacy and safety of intravenous and/or oral levofloxacin versus ceftriaxone and/or cefuroxime axetil in treatment of adults with community-acquired pneumonia.

Five hundred ninety patients were enrolled in a prospective, multicenter, randomized trial comparing the efficacy and safety of 7 to 14 days of levofloxacin treatment with that of ceftriaxone and/or cefuroxime axetil in the management of…

Group A streptococcus necrotizing fasciitis.

Necrotizing fasciitis due to Group A streptococcus has been observed with increasing frequency over the past decade. Appropriate management requires rapid recognition of this life-threatening infection and expeditious antimicrobial therapy as well as…

Chlamydia pneumoniae pneumonia.

Chlamydia pneumoniae is a common cause of community-acquired pneumonia. At present there is no "gold” standard for diagnosis and there is no easily accessible means of rapid diagnosis available. The best indication of acute C. pneumoniae infection is…

Tags: 2000, Department of Internal Medicine, File T M Jr, NEOMED College of Medicine, Seminars in respiratory and critical care medicine, Tan J S

Incidence, etiologic pathogens, and diagnostic testing of community-acquired pneumonia.

Determination of the etiologic pathogens of community-acquired pneumonia has been problematic because of the lack of reliable rapid laboratory diagnostic tools as well as the controversy concerning diagnostic criteria. In the studies reviewed here, a…

Tags: 1997, AIDS-Related Opportunistic Infections/diagnosis/microbiology, Community-Acquired Infections/diagnosis/epidemiology/microbiology, Current opinion in pulmonary medicine, Department of Internal Medicine, File T M Jr, Humans, NEOMED College of Medicine, Pneumonia/diagnosis/epidemiology/*microbiology, Tan J S

Infectious complications in diabetic patients.

Tags: *Diabetes Complications, 1997, Candidiasis/complications/therapy, Cholecystitis/complications/therapy, Current therapy in endocrinology and metabolism, Department of Internal Medicine, File T M Jr, Humans, Infection/*complications/*therapy, Infectious/complications/therapy, NEOMED College of Medicine, Respiratory Tract Infections/complications/therapy, Skin Diseases, Tan J S, Urinary Tract Infections/complications/therapy

Treatment of skin and soft-tissue infections.

Bacterial infections of the skin range from mild pyodermas to life-threatening necrotizing infections. Pyodermas are most often due to Staphylococcus aureus or beta-hemolytic Streptococcus sp, whereas infections associated with skin ulcers of the…

Tags: 1995, American journal of surgery, Bacterial Infections/complications/drug therapy/surgery/*therapy, beta-Lactamase Inhibitors, Department of Internal Medicine, Drug Combinations, Fasciitis/therapy, File T M Jr, Humans, Necrosis, NEOMED College of Medicine, Penicillanic Acid/analogs & derivatives/therapeutic use, Piperacillin/therapeutic use, Skin Diseases/complications/drug therapy/surgery/*therapy, Soft Tissue Infections/complications/drug therapy/surgery/*therapy, Surgical Wound Infection/microbiology, Tan J S, Tazobactam

International guidelines for the treatment of community-acquired pneumonia in adults: the role of macrolides.

The significance of community-acquired pneumonia (CAP) has led to the publication of guidelines from numerous international organisations. Because the macrolide class of antimicrobials is active against most of the key pathogens associated with CAP,…

Pneumonia in older adults: reversing the trend.

Tags: 2005, 80 and over, Aged, Department of Internal Medicine, File T M Jr, File Thomas M Jr, Immunization – Trends, JAMA: Journal of the American Medical Association, NEOMED College of Medicine, Pneumonia – Epidemiology – In Old Age, Pneumonia – Risk Factors, Tan J S, Tan James S

The role of atypical pathogens: Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila in respiratory infection.

Infections caused by M. pneumoniae, C. pneumoniae, and Legionella spp. are important causes of community-acquired pneumonia (CAP). In the past decade, considerable new information has come to light concerning these organisms. Despite this, debate…

Community-acquired pneumonia. What's needed for accurate diagnosis.

Characteristic clinical findings of fever, cough, and rhonchi, together with a new infiltrate on chest films and documentation of a pathogen, establish a diagnosis of infectious pneumonia. Several factors have had an impact on the approach to…

Tags: 1996, Department of Internal Medicine, File T M Jr, Humans, NEOMED College of Medicine, Plouffe J F, Pneumonia/*diagnosis/etiology, Postgraduate medicine, Tan J S

Community-acquired pneumonia: what's needed for accurate diagnosis. Symposium: first of five articles on pneumonia.

Characteristic clinical findings of fever, cough, and rhonchi, together with a new infiltrate on chest films and documentation of a pathogen, establish a diagnosis of infectious pneumonia. Several factors have had an impact on the approach to…

Tags: 1996, Continuing (Credit), Department of Internal Medicine, Education, File T M Jr, NEOMED College of Medicine, Plouffe J F, Pneumonia – Diagnosis, Postgraduate medicine, Tan J S

Antipseudomonal penicillins.

Antipseudomonal penicillins retain most of the antibacterial activity of penicillin and aminopenicillins. This group of penicillins has added activities against many gram-negative rods, including P. aeruginosa. Similar to the earlier penicillins,…

Tags: 1995, Anti-Bacterial Agents/pharmacology, Department of Internal Medicine, Drug Resistance, File T M Jr, Humans, Microbial, Microbial Sensitivity Tests, NEOMED College of Medicine, Penicillins/adverse effects/pharmacokinetics/*therapeutic use, Pseudomonas Infections/*drug therapy, Pseudomonas/*drug effects, Tan J S, The Medical clinics of North America

Diagnosis and treatment of diabetic foot infections.

Prompt clinical diagnosis and timely treatment are the hallmarks of the proper care of diabetic patients with foot infections. The importance of careful clinical foot examination cannot be overemphasized. When infection is suspected, effort should be…

Tags: 1999, Anti-Bacterial Agents/*therapeutic use, Bacterial Infections/*diagnostic imaging/*drug therapy, Bailliere's best practice & research. Clinical rheumatology, Department of Internal Medicine, Diabetic Foot/*microbiology, File T M Jr, Humans, NEOMED College of Medicine, Radiography, Tan J S

Treatment of bacteriuria in pregnancy.

The presence of bacteriuria during gestation increases the chance of acute pyelonephritis. Treatment of bacteriuria in pregnancy reduces subsequent development of symptomatic disease. Numerous studies have shown that single-dose therapy for…

Tags: 1992, Anti-Infective Agents/adverse effects, Bacteriuria/diagnosis/*drug therapy/microbiology, Department of Internal Medicine, Drugs, Female, File T M Jr, Humans, Infectious/diagnosis/*drug therapy/microbiology, NEOMED College of Medicine, Pregnancy, Pregnancy Complications, Tan J S

Management of staphylococcal and streptococcal infections.

Staphylococcus and streptococcus are bacteria commonly found on the skin and in the mucous membrane. These bacteria are frequently associated with mild cutaneous infections but may invade to cause deeper infections including necrotizing soft-tissue…

Tags: *Staphylococcal Infections/diagnosis/epidemiology/microbiology/therapy, *Streptococcal Infections/complications/diagnosis/microbiology/therapy, 1996, Anti-Bacterial Agents/pharmacology/therapeutic use, Clinics in podiatric medicine and surgery, Department of Internal Medicine, Female, File T M Jr, Humans, Male, NEOMED College of Medicine, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Tan J S

Urinary tract infections in obstetrics and gynecology.

Escherichia coli is still the most common bacterial pathogen associated with urinary tract infections in women. Because of increasing resistance, ampicillin or a sulfonamide alone is no longer recommended for the empiric treatment of those…

Tags: 1990, Anti-Bacterial Agents/pharmacology/*therapeutic use, Department of Internal Medicine, Drug Resistance, Escherichia coli/drug effects, Female, File T M Jr, Humans, Lactams, Microbial, NEOMED College of Medicine, Pregnancy, Quinolones/therapeutic use, Tan J S, The Journal of reproductive medicine, Urinary Tract Infections/*drug therapy

Ambulatory management of lower respiratory tract infections.

Clinical manifestations and radiographic findings are unreliable guides to the selection of antimicrobial therapy for lower respiratory infections. Laboratory evaluation is necessary to identify the etiologic agent. Multiple oral antibiotics are…

Tags: 1991, American family physician, Anti-Bacterial Agents/*therapeutic use, Bacterial Infections/drug therapy, Department of Internal Medicine, File T M Jr, Humans, Legionnaires' Disease/diagnosis, Mycoplasma/diagnosis, NEOMED College of Medicine, Pneumonia, Pneumonia/*diagnosis/*drug therapy, Tan J S, Thomson R B Jr

Can aggressive treatment of diabetic foot infections reduce the need for above-ankle amputation?

We retrospectively evaluated the charts of 112 patients with diabetic foot infection to determine if early aggressive surgical intervention improves outcome. All patients were classified into two groups on the basis of the timing of surgical…

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