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Superinfections of the lung. An evaluation by serial transtracheal aspirations
Abstract:
A prospective evaluation of cephaloridine, cephalothin, and lincomycin was conducted in 85 patients with pneumonia. None of the 50 with previous history of allergic sensitivity to penicillin had an allergic reaction. All cases of pure "pneumococcal pneumonia" were cured, regardless of the drug. Eight patients with polymicrobial pneumonia were cured by the cephalosporins, while lincomycin was ineffective in four patients who had polymicrobial pneumonia. Although expectorated sputum and exudates from the nasopharyngeal and oropharyngeal areas contained large concentrations of Staphylococcus aureus and various Gram-negative bacillary species during and at the end of therapy, serial cultures of transtracheal aspirate and the clinical course failed to confirm "superinfection" of the lung.
Insights
Cephalosporins and lincomycin treated pneumonia patients. Cephalosporins effectively treated polymicrobial pneumonia, while lincomycin showed limited efficacy, and no allergic reactions occurred in penicillin-sensitive patients.
Area of Science:
- Infectious Diseases
- Pharmacology
- Pulmonology
Background:
- Pneumonia treatment requires effective antimicrobial agents.
- Understanding drug efficacy in different pneumonia types is crucial.
- Assessing safety in patients with prior penicillin allergy is important.
Purpose of the Study:
- To prospectively evaluate cephaloridine, cephalothin, and lincomycin in pneumonia patients.
- To assess the efficacy of these antibiotics in pneumococcal and polymicrobial pneumonia.
- To determine the safety profile in patients with a history of penicillin allergy.
Main Methods:
- Prospective evaluation of 85 pneumonia patients.
- Administration of cephaloridine, cephalothin, and lincomycin.
- Clinical assessment and microbiological analysis including transtracheal aspirates.
Main Results:
- All 50 patients with a history of penicillin allergy tolerated the drugs without reaction.
- Pure pneumococcal pneumonia cases were cured irrespective of the antibiotic used.
- Cephalosporins were effective in 8 polymicrobial pneumonia cases; lincomycin failed in 4 such cases.
- No evidence of secondary lung superinfection was confirmed despite microbial presence in other sites.
Conclusions:
- Cephalosporins demonstrate efficacy in treating polymicrobial pneumonia.
- Lincomycin may be less effective for polymicrobial pneumonia.
- The evaluated cephalosporins are safe for patients with prior penicillin allergy.
- Antibiotic choice should consider the specific causative pathogens in pneumonia.