Bronchopulmonary infection due to B. catarrhalis. Clinical features and therapeutic response

A study was made of the clinical features and therapeutic response of 144 patients from whose sputum Branhamella catarrhalis was isolated. Typically, features of bronchopulmonary infection with cough productive of moderate amounts of purulent sputum, fever and dyspnoea were present. Of 74 patients who were infected in the community, 50 required hospital admission. Nosocomial infection occurred in the remaining 70 patients. Most patients had chronic pulmonary diseases or carcinoma bronchus; pneumonia occurred in 12 patients. Acute tracheobronchitis developed in 4 healthy non-smokers after viral illnesses. B. catarrhalis contributed to the death of 8 patients. Overall, 59% of isolates produced beta-lactamase but the proportion had risen to 70% by the end of the study; half of these were community acquired. 41% of patients who were treated initially with ampicillin did not respond. Clavulanic acid plus amoxycillin, co-trimoxazole, erythromycin, tetracycline, cefuroxime and cefotaxime are useful alternative antibiotics. All strains of B. catarrhalis were resistant to trimethoprim.