Active Ingredients: Azithromycin
Initially, treatment for TD involved a 3—5 day course of antibiotics; 2, 13, 14 however, findings from multiple randomized control trials supported the shift to single-dose regimens in recent guidelines.
Antimotility agents e. Used on its own, loperamide provides symptomatic relief over placebo, but does not result in clinical cure.
The studies involved different antibiotic regimens, including trimethoprim-sulfamethoxale, ciprofloxacin, ofloxacin, rifaximin, and azithromycin. Therefore, the role of biomarkers in the inflammatory response and their correlation to the severity of the infection continues to be a subject of growing interest.
The most studied biomarkers linked to mortality due to CAP are C-reactive protein and procalcitonin, 28 although other biomarkers are also being investigated such as pro-adrenomedullin, neopterin, copeptin and atrial natriuretic pro-peptide proANP.
Its isolated use does not provide advantages over the standard prognostic scales, but the joint use of prognostic scales and biomarkers is seen as a useful tool.
Microbiological Diagnosis Early, rapid and reliable microbiological diagnosis is essential in establishing an appropriate initial antibiotic treatment which is vital in decreasing the high mortality rate from CAP.
So, when epidemiological and risk factors that suggest uncommon aetiologies are present, the dimensions of the microbiological study to be conducted should be in accordance with the degree of severity of the patient's health status.
Furthermore, in cases of delayed resolution or a lack of treatment response, the reassessment should be more complex in the absence of prior microbiological studies.
Although S. From an epidemiological standpoint, it also requires the determination of the most common serotypes in each area in order to design the vaccinations.
Microbiological diagnosis of lower respiratory tract infections presents significant restraints due to its low cost-effectiveness and the difficulty in obtaining proper quality simples.
Interpretation of the findings in poor samples can lead to improper diagnosis and treatment errors.
In the case of pathogens which could form a part of the commensal flora such as S.
The new bacterial antigen detection techniques or amplification of nucleic acids allow the causal agent to be detected more quickly and with a higher degree of sensitivity, especially for those pathogens which are difficult to culture.
Isolating primary pathogens such as L. Blood Culture Performing blood cultures is required in the diagnosis of severe pneumonia and to make a certainty diagnosis of bacteremic pneumococcal pneumonia or H.
The blood culture must be performed through aseptic venopuncture with two different blood draws on aerobic and anaerobic mediums since pneumococcal lysis is not uncommon, allowing easier isolation of anaerobic microorganisms, in this case, under anaerobic conditions in aspiration pneumonia.
CAP is the cause in the majority of pneumococcal bacteraemias in adults.
Patients with severe pneumonia also have a higher potential for infection and in addition to S. New blood cultures should also be carried out in cases of treatment failure or in the progression of pneumonia especially in patients with risk factors.
Pleural Fluid When pleural effusion is present, a thoracentesis and aerobic and anaerobic cultures of the pleural fluid obtained are recommended since the occurrence of empyema is one of the main factors associated with poor outcome in CAP.
In pleural fluid samples, antigen detection is also indicated i. Sputum Sputum is the most common respiratory sample obtained although it is also the most problematic in its interpretation since it presents low sensitivity due to the loss of bacteria caused by the delay in processing as well as the presence of aetiological agents which are difficult to culture.
Above all, there is the problem of contamination with the oropharyngeal microbes.
Furthermore, one must be cautious in the interpretation of the results after antibiotic treatment was initiated.
When the quality of the sputum is appropriate and the process is rapid, the visualization of a predominant bacterial morphology in the Gram stain i.
The isolation of sputum in cultures is considered a probability diagnosis since the colonization of the oropharynx by pneumococci is very common in children under 2 years old and in patients with chronic pulmonary diseases.