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Diseases of Aging

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Bacterial infections

Single-celled microorganisms which can exist either as independent (free-living) organisms or as parasites (dependent upon another organism for life). Examples of bacteria include:
• Acidophilus, a normal inhabitant of yogurt,
• Chlamydia, which causes an infection very similar to gonorrhea,
• Clostridium welchii the most common cause of the dreaded gas gangrene,
• E. coli, the common peaceful citizen of our colon and, upon occasion, a dangerous agent of disease, and
• Streptococcus, the bacterium that causes the important infection of the throat strep throat.
Bacteria are widely distributed in the soil, water and air; parasitic bacteria live in humans, animals and plants. Sometimes bacteria cause diseases by producing poisons and toxins. Bacterial infections can be treated with antibiotics and other bactericides. The most common bacterial infections are meningitis, sinusitis, bronchitis, pneumonia, salmonella and tetanus.
DOXYCYCLINE
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USD 15.00
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USD 42.00
100 mg
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USD 73.00
200 mg
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USD 18.00
200 mg
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USD 49.00
200 mg
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USD 89.00
TAMIFLU
Generic name: oseltamivir
Manufacturer: Roche
Expiration date: 10/2009
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USD 0.00
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75 mg
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ZITHROMAX-SUMAMED
Substance: Azithromycin
Manufacturer: Pliva/Sanofi
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250 mg
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500 mg
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500 mg
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ZITHROMAX - GENERIC (generic - what is it?)
Substance: Azithromycin

 
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CIPRO (Ciprofloxacin)
Substance: Ciprofloxacin
Brand Name: Ciprobay
Manufacturer: Bayer Corporation

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CIPRO - GENERIC
Substance: Ciprofloxacin

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AUGMENTIN - GENERIC (generic - what is it?)
Substance: Amoxycillin
Manufacturer: Teva
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375 mg
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925 mg
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Meningitis
Inflammation of the meninges due to a bacterial infection. Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis before the 1990s, but new vaccines given to children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Streptococcus pneumoniae and Neisseria meningitidis are now the leading causes of bacterial meningitis.
High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.
The diagnosis is confirmed by examining a sample of spinal fluid obtained by a lumbar puncture (spinal tap). Treatment is started as early as possible. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly.
Some types of bacterial meningitis are contagious. The bacteria are spread through respiratory and throat secretions. This is true with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or day-care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) are at increased risk of acquiring the infection and should receive antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated against Hib disease.
There are vaccines against Hib and against some strains of N. meningitidis and many types of Streptococcus pneumoniae. The vaccines against Hib are considered safe and highly effective. There is also a vaccine that protects against four strains of N. meningitidis, but it is not routinely used in the US and is not effective in children under 18 months of age. The vaccine against N. meningitidis is sometimes used to control outbreaks of some types of meningococcal meningitis in the US. A vaccine to prevent meningitis due to S. pneumoniae (also called pneumococcal meningitis) can also prevent other forms of infection due to S. pneumoniae. The pneumococcal vaccine is not effective in children under 2 years of age but is recommended for all persons over 65 years of age and younger persons with certain chronic medical problems.
Sinusitis
Sinusitis is inflammation of the lining membrane of any of the hollow areas (sinuses) of the bone of the skull around the nose. The sinuses are directly connected to the nasal cavities.• Sinusitis is inflammation of air cavities (sinuses) in the skull.
• Sinusitis can cause pain in the face, teeth, or head.
• Sinusitis can be either infectious or non- infectious.
• Infected sinusitis is usually caused by uncomplicated virus infection.
• Bacterial infection of the sinuses is suspected when facial pain, pus nasal discharge and symptoms persist for longer than a week and are not responding to over-the-counter nasal medications.
• Bacterial sinusitis is usually treated with antibiotic therapy.
Sinusitis, when treated in an appropriate manner early in the course of the illness, can usually be treated effectively. It is important to seek the advice and evaluation of your physician if you suspect that you have sinusitis. If you are prone to recurrent bouts of sinusitis it may be important for you to consider allergy testing to see if this is the underlying cause of your recurring problem.
Bronchitis
: Inflammation and swelling of the bronchi. Bronchitis can be acute or chronic.
Chronic bronchitis usually is defined clinically as a daily cough with production of sputum for 3 months, two years in a row. In chronic bronchitis, there is inflammation and swelling of the lining of the airways that lead to narrowing and obstruction of the airways. The inflammation stimulates production of mucous (sputum), which can cause further obstruction of the airways. Obstruction of the airways, especially with mucus, increases the likelihood of bacterial lung infections.
Pneumonia
Pneumonia is an infection of one or both lungs which is usually caused by a bacteria, virus, or fungus. Prior to the discovery of antibiotics, one third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately five percent will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States.
Pneumonia can be a serious and life-threatening infection. This is true especially in the elderly, children and those that have other serious medical problems such as emphysema, heart disease, diabetes, and certain cancers. Fortunately, with the discovery of many potent antibiotics, most pneumonias are successfully treated. In fact, most pneumonias can be treated with oral antibiotics and without the need for hospitalization.
• Pneumonia is a lung infection that can be caused by different types of microorganisms.
• Symptoms of pneumonia include cough with sputum production, fever, and chest pain when breathing in.
• Diagnosis of pneumonia is suspected when a doctor hears abnormal sounds in the chest and confirmed by a chest x-ray.
• Bacteria causing pneumonia can be identified in sputum by culturing.
• A pleural effusion is a fluid collection around the inflamed lung.
• Bacterial and fungal (but not viral) pneumonia can be treated with antibiotics.
Salmonellosis
Infection with bacteria belonging to the genus Salmonella. Salmonellosis is a common cause of food poisoning as, for example, from raw eggs.
The symptoms of salmonellosis usually begin within 12 to 24 hours of exposure to the bacteria and include stomach cramps, diarrhea, fever, and sometimes vomiting. The diagnosis can be confirmed by examination of a stool sample for the Salmonella bacteria.
Most people exposed to Salmonella feel well within a few days and do not require treatment other than extra fluids. Some people need antibiotics. And a few need hospitalization for diarrhea and dehydration. Salmonellosis is particularly dangerous in people with immunodeficiency and in people with sickle cell anemia.
If the infection spreads from the intestines, it may be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.
Tetanus
Tetanus is an acute, often-fatal disease of the nervous system which is caused by bacteria called Clostridium tetani. This bacteria is found throughout the world as a normal element in the soil and in animal and human intestines.
The tetanus toxin affects the site of interaction between the nerve and the muscle that it stimulates. This region is called the neuromuscular junction. The tetanus toxin heightens the chemical signal from the nerve to the muscle which causes the muscles to continuously tighten up in a huge continuous ("tetanic" or "tonic") contraction or spasm.
During a 1 to 7 day period, progressive muscle spasms caused by the tetanus toxin in the immediate wound area may progress to involve the entire body in a set of continuous muscle contractions. Restlessness, headache, and irritability are common.
The tetanus neurotoxin causes the muscles to tighten up into a continuous ("tetanic" or "tonic") contraction or spasm. The jaw is "locked" by muscle spasms, giving the name "lockjaw" (also called "trismus"). Muscles throughout the body are affected, including the vital muscles necessary for normal breathing. When the breathing muscles lose their power, breathing becomes difficult or impossible and death can occur without life-support measures. Even with breathing support, infections of the airways within the lungs can lead to death.
General measures to treat the sources of the bacterial infection with antibiotics and drainage are carried out in the hospital while the patient is monitored for any signs of compromised breathing muscles. Sedation is often given for muscle spasm.
In more severe cases, breathing assistance with an artificial respirator machines may be needed.
The toxin already circulating in the body is neutralized with antitoxin drugs. The tetanus toxin causes no permanent damage to the nervous system after the patient recovers.
After recovery, patients still require active immunization because having the tetanus disease does not provide natural immunization against a repeat episode!
Research articles on infections
J Cyst Fibros. 2005 Mar;4(1):35-40.
Long-term azitromycin treatment of cystic fibrosis patients with chronic Pseudomonas aeruginosa infection; an observational cohort study.
Hansen CR, Pressler T, Koch C, Hoiby N.
Cystic Fibrosis Center, 5003, Department of Pediatrics, Juliane Marie Center, Rigshospitalet, Blegdamsvej 9, DK-2100 Kobenhavn O, Denmark.

BACKGROUND: In cystic fibrosis (CF), chronic endobronchial infection with Pseudomonas aeruginosa is a serious complication. Macrolides can increase lung function and weight in patients, and reduce exacerbations. METHODS: In 2001, we introduced long-term, low-dose azithromycin (AZ) treatment as an integral part of our routine treatment of these patients. Our study is an observational cohort study of all CF patients with chronic P. aeruginosa infection in our CF center comparing clinical parameters of the patients 12 months prior to treatment with the same values during 12 months of treatment. RESULTS: 45 patients (27 men, median age 29 years) completed 1-year treatment. Median weight increased from 63.1 kg in the pre-treatment period to 63.9 kg during treatment (p=0.01). Median slope of decline in lung function increased from pre-treatment FEV(1) -4.1% and FVC -3.0% to +0.8% (p<0.001) and +1.6% (p=0.01), respectively. 90% of sputum samples contained mucoid P. aeruginosa before treatment, decreasing to 81% during treatment (p=0.003). Median CRP decreased from 6.2 mmol/l to 5.8 mmol/l (ns). CONCLUSION: Long-term, low-dose AZ treatment in adult CF patients with chronic P. aeruginosa infection is safe and reduces the decline in lung function, increases weight, and reduces the percentage of mucoid strains of P. aeruginosa in sputum samples.

 

 

Drugs. 2005;65(5):605-14.
Treatment of legionnaires' disease.
Amsden GW.
Department of Adult and Pediatric Medicine, Section of Clinical Pharmacology and The Clinical Pharmacology Research Center, Bassett Healthcare, Cooperstown, New York, USA.

Legionnaires' disease is pneumonia, usually caused by Legionella pneumophila, which can range in severity from mild to quite severe. While it is commonly acquired in the community, it can just as easily be acquired nosocomially from water sources that have not been appropriately decontaminated. While historically initial treatment was always with erythromycin, current case series and treatment recommendations suggest that outpatients receive immediate treatment with one of the following antibacterials: azithromycin, erythromycin, clarithromycin, telithromycin, doxycycline or an extended-spectrum fluoroquinolone. If the symptoms are severe enough to warrant hospitalisation then the patient should receive treatment with parenteral azithromycin or extended-spectrum fluoroquinolones followed by step-down to oral formulations to complete the regimens. While a shorter course of 7-10 days for more severe infections may be possible for intravenous/oral azithromycin, other antibacterials should be administered for a total of 10-21 days and started as soon as possible upon presentation to optimise outcomes.

.
Curr Opin Infect Dis. 2003 Feb;16(1):37-41.
Pelvic inflammatory disease: how should it be managed?
Ross JD.

PURPOSE OF REVIEW To review the published literature on pelvic inflammatory disease over the past year and put into context the major findings.RECENT FINDINGS remains the commonest identified cause of pelvic inflammatory disease, and yet our understanding of how it causes mucosal damage and the factors explaining why only a subgroup of women develop pelvic inflammatory disease are not known. The increasing evidence for a chlamydial toxin may help to explain how tissue damage occurs and the indolent nature of many chlamydial infections. The evidence for as an important sexually transmitted cause of pelvic inflammatory disease is growing, with implications for treatment regimens and diagnostic testing. Power Doppler ultrasound has been reported to be both sensitive and specific in diagnosing pelvic inflammatory disease, although larger studies are needed to confirm these early results. Outpatient treatment with cefoxitin and doxycycline appears to be as effective when given in an outpatient setting compared with inpatient management with the same agents in a large randomized controlled trial with almost 3 years' follow-up.SUMMARY There remain many gaps in our knowledge of pelvic inflammatory disease, but the reviewed studies increase our understanding of the pathogenesis of infection, and offer the possibility of better diagnosis and reassurance about the long-term success of antibiotic treatment.
GMT    
16 April 2014
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