Re: Role of Atypical Bacteria and Azithromycin Therapy for Children With Recurrent Respiratory Tract Infections CME

[Guest guest]

Nelly, that was interesting although I'm not quite sure what " atypical

bacteria " are. Did you figure that out? I probably didn't read

carefully enough.

penny

[Guest guest]

M. pneumoniae and/or C. pneumoniae are what they are referring to

as 'atypical bacteria'.

S.

> Nelly, that was interesting although I'm not quite sure

what " atypical

> bacteria " are. Did you figure that out? I probably didn't read

> carefully enough.

>

> penny

[Guest guest]

Yes that's it, M. pneumoniae and C. pneumoniae are what they are referring to as 'atypical bacteria'. What they are saying is that in fact children treated with azithromycin for community acquired respiratory infections got better faster and better (fewer recurrences) than some children who weren't which they interpreted as these children being in fact infected with a bacteria and not a virus, contrarily to what public health authorities are trying to say. They do not want doctors to use abx casually for respiratory infections so they say: these "colds" are all viral in origin, abx will do not good, just create resistance in the bug populations, so doctors are strongly discourages from giving abx to combat these supposed viral infections.

In France, where most parents (mother and father) work even when their chidren are very young (3 months-olds go to child-care centres till they are 2 or 3, then to pre-school then to school), the Health Authorities have been trying to fight what they describe as "gross over prescription of abx". A media (TV/radio/press) campaign with the catchy phrase "prescribing antibiotics is not automatic" has discouraged many doctors from rxing abx, needed or not. Yet many parents, and a few doctors, have noticed that, unlike what they hear on the TV, their children do get better faster from a "cold" if they get abx, they get told it must be bec the abx are treating a secondary bacterial infection that started well after the viral infection.

They are told, it's all psychological they are just "imagining" that their kids are getting better, abx are just a psychological prop for anxious parents who want to get back to work early which has no scientific basis.

I suspect we won't be hearing too much more about such studies, especially as they are so worried about macrolide-resistant bugs.

I have personally known many families in which several members have year long respiratory infections whose endless coughing in particular just never gets better even after doctors prescribe amoxi or augmentin. They only improve after demanding longish courses of macrolides or doxy from their doctors.

Nelly

Because the infections diagnosed among children with RRTIs are usually considered to be of viral origin, it is suggested that they be treated only symptomatically.[4-6,12-14] However, our data not only indicate that the last episode of respiratory infection for children with a history of RRTIs may be associated with the presence of ******atypical bacteria in a significant number of cases but also show that **prolonged macrolide treatment can favor the resolution of the acute episode and ***reduce the number of additional respiratory infections. These data are in agreement with those reported for children with recurrent wheezing associated with atypical bacterial infections,[23,27] and they suggest that macrolide treatment of M. pneumoniae and C. pneumoniae infections can significantly modify the clinical evolution of acute respiratory diseases in both the short term and the long term. ******Because 10-day antibiotic treatment is not always effective in eradicating atypical bacteria,[34,35] we chose a ****prolonged regimen of azithromycin for cases of suspected M. pneumoniae and/or C. pneumoniae infection, although in our study ***no presumption can be made with respect to eradication.

The short term evaluation of the effectiveness of azithromycin treatment among our study patients showed that the incidence of clinical success was significantly higher among the children who received azithromycin than among those who received symptom-specific agents alone, mainly because of the activity of azithromycin against atypical bacteria. The importance of the antimicrobial effect of azithromycin in the short term was supported by the fact that only patients with atypical bacterial infections received advantages from the administration of macrolides, whereas patients without atypical bacterial infections had similar outcomes regardless of the treatment group. In contrast, the long term efficacy of azithromycin, although greater among patients with atypical bacterial infections, was not related to the cause of the respiratory disease. The reduction in the number of new episodes of respiratory infection caused by M. pneumoniae and/or C. pneumoniae could again be attributed to the antimicrobial activity for atypical bacteria, *****but the favorable outcomes among patients without atypical bacterial infections might have been related to the ****antiinflammatory properties of macrolides. *****In this regard, it is thought that macrolides interact with the natural effectors involved in inflammation, *****although the importance of this property has not yet been fully elucidated.*****

[infections] Re: Role of Atypical Bacteria and Azithromycin Therapy for Children With Recurrent Respiratory Tract Infections CME

M. pneumoniae and/or C. pneumoniae are what they are referring to as 'atypical bacteria'. S.> Nelly, that was interesting although I'm not quite sure what "atypical > bacteria" are. Did you figure that out? I probably didn't read > carefully enough.> > penny

[Guest guest]

This is very similar to how they treat cystic fibrosis in this

country and panobrocnhio something or other in Japan (with Zith).

Except treatments practically for life.

The papers I've read on that subject suggest that the pathogens are

not erradicated, but rather just kept in colony form. Lack of the

ability to be able to erradicate the pathogen is pretty much now

considered geneic in cystic fibrosis.

SO, the normal kids in the paper below with the variants - Zith

sounds like it's the way to go.

B.

> http://www.medscape.com/viewprogram/4369_pnt

>

>

> From The Pediatric Infectious Disease Journal

> Role of Atypical Bacteria and Azithromycin Therapy for Children

With Recurrent Respiratory Tract Infections CME

> Authors: na Esposito, MD; Bosis, MD; Nadia Faelli,

MD; Enrica Begliatti, MD; a Droghetti, MD; Elena Tremolati, MD;

Alessandro Porta, MD; Francesco Blasi, MD; Nicola Principi, MD

>

> Complete author affiliations and disclosures are at the end of this

activity.

>

>

> Pediatr Infect Dis J 24(5):438-444, 2005. © 2005 Lippincott

& Wilkins

>

>

> Abstract and Introduction

>

> Abstract

> Background: The aim of this study of 352 patients, 1-14 years of

age, with acute respiratory infections and a history of recurrent

respiratory tract infections (RRTIs), and 208 healthy subjects was to

evaluate whether Mycoplasma pneumoniae and Chlamydia pneumoniae

played a role in causing acute respiratory episodes among children

with RRTIs and whether specific antibiotic treatment for these

bacteria could improve the acute episodes and reduce recurrences.

> Methods: The patients were blindly randomized to receive

azithromycin (10 mg/kg/d for 3 days weekly, for 3 weeks) together

with symptom-specific agents or symptom-specific agents alone. Acute

M. pneumoniae and/or C. pneumoniae infection was diagnosed if the

child had a significant antibody response in paired sera and/or if

the DNA of the bacteria was detected in nasopharyngeal aspirates.

> Results: Atypical bacterial infections were identified for 190

patients (54.0%) and 8 healthy control subjects (3.8%; P < 0.0001).

Short term (1-month) clinical success was significantly more frequent

among the patients who had received azithromycin together with

symptom-specific agents than among those who had received symptom-

specific agents alone, but the difference was significant only for

the group of patients with atypical bacteria. In contrast, long term

(6-month) clinical success was significantly more frequent among the

patients who had received azithromycin in addition to symptom-

specific agents, regardless of whether they experienced infections

with atypical bacteria or other pathogens, although positive outcomes

were significantly more frequent among those with atypical bacteria.

> Conclusions: Atypical bacteria seem to play a role among children

with RRTIs, and prolonged azithromycin therapy can significantly

improve the acute episodes and reduce the risk of recurrences.

>

>

> Discussion

>

> Taking in account the very low prevalence of atypical bacterial

infections among our healthy control subjects, in comparison with the

patients with a history of RRTIs, our results confirm that atypical

bacteria play a role in causing both upper and lower respiratory

tract infections among pediatric patients, with M. pneumoniae being

more important. However, in addition to our previously published

reports,[17-20,24-27] these data seem to indicate that infections

caused by these bacteria may be associated not only with pharyngitis,

acute bronchitis, wheezing and pneumonia but also with rhinosinusitis

and croup, thus emphasizing that the entire respiratory tract can be

infected.

>

> This study adds additional information concerning the relationship

between atypical bacteria and frequent recurrences of respiratory

diseases, which was demonstrated previously only in some studies of

patients with recurrent pharyngitis or recurrent wheezing.[23-

25,27,33] However, considering that M. pneumoniae and C. pneumoniae

may involve various sections of the respiratory tract, it is not

surprising that at least some of the infections found among children

with RRTIs can be caused by these pathogens. Because we found no

seasonal differences in the incidence of M. pneumoniae and/or C.

pneumoniae infections during the study period, it seems that atypical

bacterial infections are not related to clear local outbreaks.

>

> Because the infections diagnosed among children with RRTIs are

usually considered to be of viral origin, it is suggested that they

be treated only symptomatically.[4-6,12-14] However, our data not

only indicate that the last episode of respiratory infection for

children with a history of RRTIs may be associated with the presence

of atypical bacteria in a significant number of cases but also show

that prolonged macrolide treatment can favor the resolution of the

acute episode and reduce the number of additional respiratory

infections. These data are in agreement with those reported for

children with recurrent wheezing associated with atypical bacterial

infections,[23,27] and they suggest that macrolide treatment of M.

pneumoniae and C. pneumoniae infections can significantly modify the

clinical evolution of acute respiratory diseases in both the short

term and the long term. Because 10-day antibiotic treatment is not

always effective in eradicating atypical bacteria,[34,35] we chose a

prolonged regimen of azithromycin for cases of suspected M.

pneumoniae and/or C. pneumoniae infection, although in our study no

presumption can be made with respect to eradication.

>

> The short term evaluation of the effectiveness of azithromycin

treatment among our study patients showed that the incidence of

clinical success was significantly higher among the children who

received azithromycin than among those who received symptom-specific

agents alone, mainly because of the activity of azithromycin against

atypical bacteria. The importance of the antimicrobial effect of

azithromycin in the short term was supported by the fact that only

patients with atypical bacterial infections received advantages from

the administration of macrolides, whereas patients without atypical

bacterial infections had similar outcomes regardless of the treatment

group. In contrast, the long term efficacy of azithromycin, although

greater among patients with atypical bacterial infections, was not

related to the cause of the respiratory disease. The reduction in the

number of new episodes of respiratory infection caused by M.

pneumoniae and/or C. pneumoniae could again be attributed to the

antimicrobial activity for atypical bacteria, but the favorable

outcomes among patients without atypical bacterial infections might

have been related to the antiinflammatory properties of macrolides.

In this regard, it is thought that macrolides interact with the

natural effectors involved in inflammation, although the importance

of this property has not yet been fully elucidated.[36,37] Although

it is necessary to confirm our results with additional studies, our

data suggest that a child with a history of RRTIs who is experiencing

an acute episode of respiratory infection should be evaluated for

infections caused by atypical bacteria and, when the results are

positive, macrolide therapy should be considered to improve the

course of the disease and to reduce the risk of recurrences.

>

> Presented in part at the 42nd Interscience Conference on

Antimicrobial Agents and Chemotherapy, San Diego, CA, September 27-

30, 2002.

>

> Reprint Address

> Nicola Principi, MD, Institute of Pediatrics, Fondazione IRCCS

Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, University

of Milan, Via Commenda 9, 20122 Milan, Italy. Fax 39-02-50320226; E-

mail: nicola.principi@u...

[Guest guest]

Inhaled glutathione seems to be helping the cystic fibrosis kids, btw.

> > http://www.medscape.com/viewprogram/4369_pnt

> >

> >

> > From The Pediatric Infectious Disease Journal

> > Role of Atypical Bacteria and Azithromycin Therapy for Children

> With Recurrent Respiratory Tract Infections CME

> > Authors: na Esposito, MD; Bosis, MD; Nadia Faelli,

> MD; Enrica Begliatti, MD; a Droghetti, MD; Elena Tremolati,

MD;

> Alessandro Porta, MD; Francesco Blasi, MD; Nicola Principi, MD

> >

> > Complete author affiliations and disclosures are at the end of

this

> activity.

> >

> >

> > Pediatr Infect Dis J 24(5):438-444, 2005. © 2005 Lippincott

> & Wilkins

> >

> >

> > Abstract and Introduction

> >

> > Abstract

> > Background: The aim of this study of 352 patients, 1-14 years of

> age, with acute respiratory infections and a history of recurrent

> respiratory tract infections (RRTIs), and 208 healthy subjects was

to

> evaluate whether Mycoplasma pneumoniae and Chlamydia pneumoniae

> played a role in causing acute respiratory episodes among children

> with RRTIs and whether specific antibiotic treatment for these

> bacteria could improve the acute episodes and reduce recurrences.

> > Methods: The patients were blindly randomized to receive

> azithromycin (10 mg/kg/d for 3 days weekly, for 3 weeks) together

> with symptom-specific agents or symptom-specific agents alone.

Acute

> M. pneumoniae and/or C. pneumoniae infection was diagnosed if the

> child had a significant antibody response in paired sera and/or if

> the DNA of the bacteria was detected in nasopharyngeal aspirates.

> > Results: Atypical bacterial infections were identified for 190

> patients (54.0%) and 8 healthy control subjects (3.8%; P < 0.0001).

> Short term (1-month) clinical success was significantly more

frequent

> among the patients who had received azithromycin together with

> symptom-specific agents than among those who had received symptom-

> specific agents alone, but the difference was significant only for

> the group of patients with atypical bacteria. In contrast, long

term

> (6-month) clinical success was significantly more frequent among

the

> patients who had received azithromycin in addition to symptom-

> specific agents, regardless of whether they experienced infections

> with atypical bacteria or other pathogens, although positive

outcomes

> were significantly more frequent among those with atypical bacteria.

> > Conclusions: Atypical bacteria seem to play a role among children

> with RRTIs, and prolonged azithromycin therapy can significantly

> improve the acute episodes and reduce the risk of recurrences.

> >

> >

> > Discussion

> >

> > Taking in account the very low prevalence of atypical bacterial

> infections among our healthy control subjects, in comparison with

the

> patients with a history of RRTIs, our results confirm that atypical

> bacteria play a role in causing both upper and lower respiratory

> tract infections among pediatric patients, with M. pneumoniae being

> more important. However, in addition to our previously published

> reports,[17-20,24-27] these data seem to indicate that infections

> caused by these bacteria may be associated not only with

pharyngitis,

> acute bronchitis, wheezing and pneumonia but also with

rhinosinusitis

> and croup, thus emphasizing that the entire respiratory tract can

be

> infected.

> >

> > This study adds additional information concerning the

relationship

> between atypical bacteria and frequent recurrences of respiratory

> diseases, which was demonstrated previously only in some studies of

> patients with recurrent pharyngitis or recurrent wheezing.[23-

> 25,27,33] However, considering that M. pneumoniae and C. pneumoniae

> may involve various sections of the respiratory tract, it is not

> surprising that at least some of the infections found among

children

> with RRTIs can be caused by these pathogens. Because we found no

> seasonal differences in the incidence of M. pneumoniae and/or C.

> pneumoniae infections during the study period, it seems that

atypical

> bacterial infections are not related to clear local outbreaks.

> >

> > Because the infections diagnosed among children with RRTIs are

> usually considered to be of viral origin, it is suggested that they

> be treated only symptomatically.[4-6,12-14] However, our data not

> only indicate that the last episode of respiratory infection for

> children with a history of RRTIs may be associated with the

presence

> of atypical bacteria in a significant number of cases but also show

> that prolonged macrolide treatment can favor the resolution of the

> acute episode and reduce the number of additional respiratory

> infections. These data are in agreement with those reported for

> children with recurrent wheezing associated with atypical bacterial

> infections,[23,27] and they suggest that macrolide treatment of M.

> pneumoniae and C. pneumoniae infections can significantly modify

the

> clinical evolution of acute respiratory diseases in both the short

> term and the long term. Because 10-day antibiotic treatment is not

> always effective in eradicating atypical bacteria,[34,35] we chose

a

> prolonged regimen of azithromycin for cases of suspected M.

> pneumoniae and/or C. pneumoniae infection, although in our study no

> presumption can be made with respect to eradication.

> >

> > The short term evaluation of the effectiveness of azithromycin

> treatment among our study patients showed that the incidence of

> clinical success was significantly higher among the children who

> received azithromycin than among those who received symptom-

specific

> agents alone, mainly because of the activity of azithromycin

against

> atypical bacteria. The importance of the antimicrobial effect of

> azithromycin in the short term was supported by the fact that only

> patients with atypical bacterial infections received advantages

from

> the administration of macrolides, whereas patients without atypical

> bacterial infections had similar outcomes regardless of the

treatment

> group. In contrast, the long term efficacy of azithromycin,

although

> greater among patients with atypical bacterial infections, was not

> related to the cause of the respiratory disease. The reduction in

the

> number of new episodes of respiratory infection caused by M.

> pneumoniae and/or C. pneumoniae could again be attributed to the

> antimicrobial activity for atypical bacteria, but the favorable

> outcomes among patients without atypical bacterial infections might

> have been related to the antiinflammatory properties of macrolides.

> In this regard, it is thought that macrolides interact with the

> natural effectors involved in inflammation, although the importance

> of this property has not yet been fully elucidated.[36,37] Although

> it is necessary to confirm our results with additional studies, our

> data suggest that a child with a history of RRTIs who is

experiencing

> an acute episode of respiratory infection should be evaluated for

> infections caused by atypical bacteria and, when the results are

> positive, macrolide therapy should be considered to improve the

> course of the disease and to reduce the risk of recurrences.

> >

> > Presented in part at the 42nd Interscience Conference on

> Antimicrobial Agents and Chemotherapy, San Diego, CA, September 27-

> 30, 2002.

> >

> > Reprint Address

> > Nicola Principi, MD, Institute of Pediatrics, Fondazione IRCCS

> Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena,

University

> of Milan, Via Commenda 9, 20122 Milan, Italy. Fax 39-02-50320226; E-

> mail: nicola.principi@u...

[Guest guest]

What categorizes them as " atypical " ? I don't get it. Are they saying

children don't often get these bugs? That's kind of ridiculous.

Especially if no one's a.looking, or b.cultivating them successfully.

penny

> > Nelly, that was interesting although I'm not quite sure

> what " atypical

> > bacteria " are. Did you figure that out? I probably didn't read

> > carefully enough.

> >

> > penny

[Guest guest]

May explain why Zith seems to help me (but was more slow to work

than some other abx). I was a kid with chronic respiratory

infections (that disappeared when I got full blown " CFS " ). I'm

probably just keeping my colonies under control. I'm also taking

penicillin every 3 or 4 hours, and when I go longer, I immediately

can tell that the bacteria are becoming more active (I have one

tooth that's a barometer for me), so I pop another penicillin, and

it quiets right back down.

So now I've got to hit them with something really hard, and hope I

can start totally eradicating them. Maybe the flagyl (which I'm

scared to death of. :-) I'm going to try the pulsing as suggested.

Also, it may be time to start looking for another abx. The last

thing I want is for these bugs to get the upper hand, but I'm

encouraged that people seem to be able to stay on both zith and

penicillin for long periods of time without building resistance.

Fingers crossed.

penny

> > http://www.medscape.com/viewprogram/4369_pnt

> >

> >

> > From The Pediatric Infectious Disease Journal

> > Role of Atypical Bacteria and Azithromycin Therapy for Children

> With Recurrent Respiratory Tract Infections CME

> > Authors: na Esposito, MD; Bosis, MD; Nadia Faelli,

> MD; Enrica Begliatti, MD; a Droghetti, MD; Elena Tremolati,

MD;

> Alessandro Porta, MD; Francesco Blasi, MD; Nicola Principi, MD

> >

> > Complete author affiliations and disclosures are at the end of

this

> activity.

> >

> >

> > Pediatr Infect Dis J 24(5):438-444, 2005. © 2005 Lippincott

> & Wilkins

> >

> >

> > Abstract and Introduction

> >

> > Abstract

> > Background: The aim of this study of 352 patients, 1-14 years of

> age, with acute respiratory infections and a history of recurrent

> respiratory tract infections (RRTIs), and 208 healthy subjects was

to

> evaluate whether Mycoplasma pneumoniae and Chlamydia pneumoniae

> played a role in causing acute respiratory episodes among children

> with RRTIs and whether specific antibiotic treatment for these

> bacteria could improve the acute episodes and reduce recurrences.

> > Methods: The patients were blindly randomized to receive

> azithromycin (10 mg/kg/d for 3 days weekly, for 3 weeks) together

> with symptom-specific agents or symptom-specific agents alone.

Acute

> M. pneumoniae and/or C. pneumoniae infection was diagnosed if the

> child had a significant antibody response in paired sera and/or if

> the DNA of the bacteria was detected in nasopharyngeal aspirates.

> > Results: Atypical bacterial infections were identified for 190

> patients (54.0%) and 8 healthy control subjects (3.8%; P <

0.0001).

> Short term (1-month) clinical success was significantly more

frequent

> among the patients who had received azithromycin together with

> symptom-specific agents than among those who had received symptom-

> specific agents alone, but the difference was significant only for

> the group of patients with atypical bacteria. In contrast, long

term

> (6-month) clinical success was significantly more frequent among

the

> patients who had received azithromycin in addition to symptom-

> specific agents, regardless of whether they experienced infections

> with atypical bacteria or other pathogens, although positive

outcomes

> were significantly more frequent among those with atypical

bacteria.

> > Conclusions: Atypical bacteria seem to play a role among

children

> with RRTIs, and prolonged azithromycin therapy can significantly

> improve the acute episodes and reduce the risk of recurrences.

> >

> >

> > Discussion

> >

> > Taking in account the very low prevalence of atypical bacterial

> infections among our healthy control subjects, in comparison with

the

> patients with a history of RRTIs, our results confirm that

atypical

> bacteria play a role in causing both upper and lower respiratory

> tract infections among pediatric patients, with M. pneumoniae

being

> more important. However, in addition to our previously published

> reports,[17-20,24-27] these data seem to indicate that infections

> caused by these bacteria may be associated not only with

pharyngitis,

> acute bronchitis, wheezing and pneumonia but also with

rhinosinusitis

> and croup, thus emphasizing that the entire respiratory tract can

be

> infected.

> >

> > This study adds additional information concerning the

relationship

> between atypical bacteria and frequent recurrences of respiratory

> diseases, which was demonstrated previously only in some studies

of

> patients with recurrent pharyngitis or recurrent wheezing.[23-

> 25,27,33] However, considering that M. pneumoniae and C.

pneumoniae

> may involve various sections of the respiratory tract, it is not

> surprising that at least some of the infections found among

children

> with RRTIs can be caused by these pathogens. Because we found no

> seasonal differences in the incidence of M. pneumoniae and/or C.

> pneumoniae infections during the study period, it seems that

atypical

> bacterial infections are not related to clear local outbreaks.

> >

> > Because the infections diagnosed among children with RRTIs are

> usually considered to be of viral origin, it is suggested that

they

> be treated only symptomatically.[4-6,12-14] However, our data not

> only indicate that the last episode of respiratory infection for

> children with a history of RRTIs may be associated with the

presence

> of atypical bacteria in a significant number of cases but also

show

> that prolonged macrolide treatment can favor the resolution of the

> acute episode and reduce the number of additional respiratory

> infections. These data are in agreement with those reported for

> children with recurrent wheezing associated with atypical

bacterial

> infections,[23,27] and they suggest that macrolide treatment of M.

> pneumoniae and C. pneumoniae infections can significantly modify

the

> clinical evolution of acute respiratory diseases in both the short

> term and the long term. Because 10-day antibiotic treatment is not

> always effective in eradicating atypical bacteria,[34,35] we chose

a

> prolonged regimen of azithromycin for cases of suspected M.

> pneumoniae and/or C. pneumoniae infection, although in our study

no

> presumption can be made with respect to eradication.

> >

> > The short term evaluation of the effectiveness of azithromycin

> treatment among our study patients showed that the incidence of

> clinical success was significantly higher among the children who

> received azithromycin than among those who received symptom-

specific

> agents alone, mainly because of the activity of azithromycin

against

> atypical bacteria. The importance of the antimicrobial effect of

> azithromycin in the short term was supported by the fact that only

> patients with atypical bacterial infections received advantages

from

> the administration of macrolides, whereas patients without

atypical

> bacterial infections had similar outcomes regardless of the

treatment

> group. In contrast, the long term efficacy of azithromycin,

although

> greater among patients with atypical bacterial infections, was not

> related to the cause of the respiratory disease. The reduction in

the

> number of new episodes of respiratory infection caused by M.

> pneumoniae and/or C. pneumoniae could again be attributed to the

> antimicrobial activity for atypical bacteria, but the favorable

> outcomes among patients without atypical bacterial infections

might

> have been related to the antiinflammatory properties of

macrolides.

> In this regard, it is thought that macrolides interact with the

> natural effectors involved in inflammation, although the

importance

> of this property has not yet been fully elucidated.[36,37]

Although

> it is necessary to confirm our results with additional studies,

our

> data suggest that a child with a history of RRTIs who is

experiencing

> an acute episode of respiratory infection should be evaluated for

> infections caused by atypical bacteria and, when the results are

> positive, macrolide therapy should be considered to improve the

> course of the disease and to reduce the risk of recurrences.

> >

> > Presented in part at the 42nd Interscience Conference on

> Antimicrobial Agents and Chemotherapy, San Diego, CA, September 27-

> 30, 2002.

> >

> > Reprint Address

> > Nicola Principi, MD, Institute of Pediatrics, Fondazione IRCCS

> Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena,

University

> of Milan, Via Commenda 9, 20122 Milan, Italy. Fax 39-02-50320226;

E-

> mail: nicola.principi@u...

[Guest guest]

It may be cause M is a mycoplasma and C is a weird little bacterium -

I think for a while it was not too clear that it was a bacterium.

> > > Nelly, that was interesting although I'm not quite sure

> > what " atypical

> > > bacteria " are. Did you figure that out? I probably didn't read

> > > carefully enough.

> > >

> > > penny

[Guest guest]

Atypical usually means something variant-. A variant can morph back

and forth between the classical form and the atypical variant.

They usually use the word resistant when they mean something has

mutated into a resistant strain... and it stays in this form.

Barb

> > > Nelly, that was interesting although I'm not quite sure

> > what " atypical

> > > bacteria " are. Did you figure that out? I probably didn't read

> > > carefully enough.

> > >

> > > penny

[Guest guest]

" penny " <pennyhoule@y...> wrote:

> What categorizes them as " atypical " ? I don't get it. Are they

saying children don't often get these bugs? That's kind of

ridiculous. Especially if no one's a.looking, or b.cultivating them

successfully.

Penny, these are myocplasma - part of what makes them atypical is

that they can't be cultured, which is why if you read the study they

used antibody and pcr evidence to identify them.

>

> penny

>

>

> > > Nelly, that was interesting although I'm not quite sure

> > what " atypical

> > > bacteria " are. Did you figure that out? I probably didn't read

> > > carefully enough.

> > >

> > > penny

[Guest guest]

Not 100% true. There are a number of ways for c.pneumonia to be

identified other than pcr testing, but if nobody's looking...?

Atypical is a " misnomer " as far as I'm concerned. I think Nelly

pinpointed it. They're " atypical " because tptb don't want to admit

they exist.

penny

> > > > Nelly, that was interesting although I'm not quite sure

> > > what " atypical

> > > > bacteria " are. Did you figure that out? I probably didn't

read

> > > > carefully enough.

> > > >

> > > > penny