Respiratory Infections today
Written By:
Jennifer L. Merecido, MD, FPAFP
The world-famous proverb that goes “health is wealth” is so true especially nowadays that the costs of medicine is high. It is not good to be sick. Nobody wants to be sick. I would say, today, health is more valuable. Your being healthy is your capital to everything that you can do. You can live a better life if you are healthy.
The onslaught of Covid 19 virus brought many changes to our daily lives these days. We became limited to many of our activities. When one is infected with a respiratory tract infection, we become more worried.
Respiratory tract infections (RTIs) which are infections of parts of the body involved in breathing, such as the sinuses, throat, airways or lungs are common occurrence especially on rainy days. While it is true that most RTIs get better without treatment, the presence of covid around made a different scenario in these RTIs today.
These days, RTIs’ become more worrisome because having it (RTIs) could mean many things - one primary consideration would be a covid infection, such that, the one with RTIs should isolate himself, and that he has to inform his workplace that he has respiratory infections and that they have to observe themselves, that if they develop symptoms of infection then they have to isolate. If the infected one is the breadwinner of the family, whose income is dependent on the number of days of work only, it could mean no income to the family. For those group of patients who are immunocompromised especially the elderly and those who are suffering from other diseases like cancer, diabetes, kidney disease, a respiratory tract infection involving the lung would mean pneumonia- risk hence a coverage of antibiotic is almost always warranted.
In cases where pneumonia is considered, one medicine that can be used is the Azithromycin.
Azithromycin [9-deoxo-9a-aza-9a-methyl-9a-homoerythromycin] is a part of the azalide subclass of macrolides, and contains a 15-membered ring, with a methyl-substituted nitrogen instead of a carbonyl group at the 9a position on the aglycone ring, which allows for the prevention of its metabolism. This differentiates azithromycin from other types of macrolides.[1]
Macrolides stop bacterial growth by inhibiting protein synthesis and translation, treating bacterial infections.[1] Azithromycin has additional immunomodulatory effects and has been used in chronic respiratory inflammatory diseases for this purpose.[2]
In order to replicate, bacteria require a specific process of protein synthesis, enabled by ribosomal proteins.[3] Azithromycin binds to the 23S rRNA of the bacterial 50S ribosomal subunit. It stops bacterial protein synthesis by inhibiting the transpeptidation/translocation step of protein synthesis and by inhibiting the assembly of the 50S ribosomal subunit.[Label, 4] This results in the control of various bacterial infections.[Label, 5] The strong affinity of macrolides, including azithromycin, for bacterial ribosomes, is consistent with their broad‐spectrum antibacterial
activities.[5]
Azithromycin is highly stable at a low pH, giving it a longer serum half-life and increasing its concentrations in tissues compared to erythromycin.[1]
Azithromycin is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the microorganisms listed in the specific conditions below. Recommended dosages, duration of therapy and considerations for various patient populations may vary among these infections. Refer to the FDA label and "Indications" section of this drug entry for detailed information.
Adults
- Acute bacterial exacerbations of chronic obstructive pulmonary disease due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae.
- Acute bacterial sinusitis due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae.
- Community-acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy.
- Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy. Uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae. Abscesses usually require surgical drainage.
- Urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae.
- Genital ulcer disease in men due to Haemophilus ducreyi (chancroid). Due to the small number of women included in clinical trials, the efficacy of azithromycin in the treatment of chancroid in women has not been established.
Pediatric Patients
- Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae.
- Community-acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy.
- Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy.
In my practice as a family physician who caters to patients from all ages and from all walks of life, I find it helpful to have available medicines that could effectively address one of the common illnesses around. It is also good that these medicines are made more affordable to most of the patients needing it by NURTURE MED PHARMA INC. with their brand of azithromycin (AZITHRODYN).
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