PARENTERAL CEPHALOSPORINS FOR THE TREATME NT OF LOWER RESPIRATORY-TRACT INFECTIONS - CLINICAL-EXPERIENCE WITH CEFUROXIME

In most cases of respiratory tract infection, antibiotic therapy has t o be initiated before the results of microbiological examination are a vailable. The four most common pathogens of acute exacerbations of chr onic bronchitis are pneumococci, Haemophilus influenzae, Moraxella cat arrhalis and Staphylococcus aureus. Pneumococci are the predominant pa thogens of community-acquired pneumonia, followed by H. influenzae and staphyloccoci. Legionella, mycoplasma and chlamydia vary in frequency according to the population studied. Staphylococci, Pseudomonas, Ente robacter and Klebsiella spp. as well as H. influenzae are the major pa thogens of secondary pneumonia. For reasons of cost and environmental problems, oral antibiotics ought to be used whenever possible consider ing the severity of the infection and patient circumstance. Parenteral antibiotics are indicated in severe infections in order to provide hi gh therapeutic drug levels. Second generation cephalosporins are appro priate for initial therapy of lower respiratory tract infections. In c ase of severe infection, cephalosporins should be combined with an ami noglycoside, ureidopenicillin or quinolone. Cefuroxime has shown good clinical efficacy and tolerance in lower respiratory tract infections.