The Clinical effiency of antimicrobial therapy depend on the pharmacokinectic/pharmacodynamic parameters of antibiotics except antibacterial spectrum and activity. The penetration of antibiotics in the respiratory organ and pharmacokinectic/pharmacodynamic parameters correlating with antibacterial efficiency are descrided. It is emphasized that antibiotic treatment regime on the pulmonary infections should be based the pharmacokinectic/pharmacodynamic principle.

In the light of inappropriate use and confused assessment for the respiratory quinolone antimicrobial agents,this paper discussed four aspects,e.g.development on indications of respiratory quinolone use,new evidences of CAP treatment with Moxifloxacin and its significance,evaluation of collateral damage of quinolone antimicrobial agents and notices of quinolone use.

Resistance to antibiotic therapy is a worldwide problem with severe clinical and economic consequences.Among hospitalized patients,antibiotic resistance has been associated with increases in morbidity and mortality,prolonged hospitalization,and increased hospital costs.An important cause of antibiotic resistance is the selection of resistant bacterial strains as a result of inappropriate and/or excessive antibiotic prescribing in the hospital setting;important strategies to control resistance include monitoring and auditing drug use as well as surveillance and reporting of resistance patterns among hospital flora.Traditional antibiotics,such as cephalosporins and fluoroquinolones,are often linked to the emergence of multidrug-resistant gram-negative bacteria,particularly acinetobacter and pseudomonas spp,and increasingly,enterobacteriaceae.Accordingly,the treatment strategy is to think to choose an antibiotics with adequate infection control and lower resistance selection.Studies of relation between antibiotic consumption and antibiotic resistance show that ertapenem,a group 1 carbapenem,can not reduce the susceptibly of other antibiotics to pseudomonas spp,enterobacteriaceae and the others,and be benefit on hospital ecology. Abstract:Summ ary:Resistance to antib iotic therapy is a worldw ide prob lem w ith severe c lin ical and econom ic consequences.A-mong hosp italized patients,antib iotic resistance has been assoc iated w ith increases in morb id ity and mortality,prolonged hosp italization,and increased hosp ital costs.An important cause of antib iotic resistance is the selection of resistant bacteri-al strains as a resu lt of inappropriate and /or excessive antib iotic prescrib ing in the hosp ital setting;important strategies to control resistance inc lude mon itoring and aud iting drug use as well as surve illance and reporting of resistance patterns a-mong hosp ital flora.Trad itional antib iotics,such as cephalosporins and fluoroqu inolones,are often linked to the em ergence ofmu ltidrug-resistant gram-negative bacteria,particu larly ac inetobacter and pseudomonas spp,and increasingly,enterobac-teriaceae.Accord ingly,the treatm ent strategy is to th ink to choose an antib iotics w ith adequate infection control and lower resistance selection.Stud ies of relation between antib iotic consumption and antib iotic resistance show that ertapenem,a group 1 carbapenem,can not reduce the susceptib ly of other antib iotics to pseudomonas spp,enterobacteriaceae and the others,and be benefit on hosp ital ecology.

Common feactures of pnemocystis pneumonia(PCP) complicated AIDS and non-AIDS imunnocomprised host were fever,progressive dyspnea and radiographic diffuse interstitial infiltration.There are also obvious differences between them,including the former have more moderate symptoms,fewer organism load in pulmonary,more lightly neutrophil inflammatory reaction,slower response and more adverse effect of treatment with SMZco.Recognizing these characters will help to find PCP early and give timely diagnosis and treatment. Abstract:Summ ary: Common feactures of pnemocystis pneumon ia(PCP) comp licated AIDS and non-AIDS imunnocomprised host were fever,progressive dyspnea and rad iograph ic d iffuse interstitial infiltration.There are also obvious d ifferences be-tween them,inc lud ing the form er have more moderate symp-tom s,fewer organ ism load in pu lmonary,more lightly neutroph il inflamm atory reaction,slower response and more adverse effect of treatm entw ith SMZco.Recogn izing these characters w ill help to find PCP early and give tim ely d iagnosis and treatm ent.

Current concerned topics for community-acquired pneumonia(CAP)have been reviewed.There are 3 aspects,including(1)the modified penicillin susceptibility breakpoint of Streptococcus pneumonia and choice of antibiotics treating CAP.(2)Risk factors,which may influence CAP conditions and pathogens were evaluated.(3)Severe CAP and complicating severe sepsis and controversy of glucocorticoid treatment.

Virus infection is a cause of respiratory tract infections and predisposes the patients to secondary bacterial infections. With the graying” of the population and the increase of organ transplantation, immunocompromised hosts (ICH) and the rate of human immunodeficiency virus (HIV) infection as well as the emergence of such new pathogens as Hantavirus and Ebola virus in recent years, the morbidity of respiratory tract infections is growing high. There come the new challenges in the management of the respiratory tract infections. This paper is to introduce the application of antiviral drugs in the treatment of respiratory tract infections and discuss about the methodology of the administration of these drugs.

Objective To explore the risk factors of septicemia in hospitals. Methods A retrospective control study of cases was conducted, using SPSS software to conduct single factor and Iogistic regression analysis so as to screen possible risk ractors. Results Differences of 14 factors were shown to be statistically significant in the analysis of single factors. Further Iogistic regreasion analysis of the 14 factors indicate that the following are independent risk factors of septicemia in hospitals: basic diseases(OR = 5.3), tumor chemotherapy(OR=15.9), albumin＜30g/L(0R=5.9), vascular catheterization ＞ 2 days(OR= 5.2), operation time＞ 4 hours(OR= 4.9), continuous use of antibiotics(OR=1.1), and simultaneous use of more than 2 kinds of antibiotics(OR= 9.0).Conclusion Septicemia in hospitals results from the synergistic effect of a variety of factors. The possible risk factors that have been screened need to be further confirmed through perspective studies and clinical trials.

Objective To study the alteration of surfactant protein A and D(sp-A,SP-D)result-ing from pneumcystis carinil pneumonia(PCP)and investigate its implication in the pathogenesis of PCP.Methods SD rat models of PCP were induced by subcutaneous injection of 25 mg cortisone acetate,normal control and negative control as well as bacterial pneumonia group were set up for comparison.During 8～12weeks.broncboalveolar lavage fluid (BALF) of rats was collected.Total nucleate cells of BALF were counted and differentiated as well as the concentrations of surfactant protein A(SP-A)and surfactant pro-tein D(SP-D)were measured by immunoblotting assay.Results The rats were divided into three im-munosuppressive groups,plus a norrflal control group. Group A: normal control(n=6)consisted of healthy SD rats;group B:negative control(n=6)employed rats with cortisone acetate injection over 8weekz without tung infection;group C:bacterial pneumonia(n=11),rats were injected with cortisone ac-etate over 8 weeks and resulted in bacterial pneumonia without other pathogens isolated;group D(n=14):rats were injected with cortisone acetate during 8～12 weeks and resulted in PCP without other pathogens isolated.During PCP infection,the total cell counts and the percentage of polymorphonuclears (PMNs)in BALF were significantly increased(P<0.01),but were lower than those in the bacterial pneumonia group.The concentration of SP-A of BALF in PCP(45.1 μg/ml 4±22.1 μg/m1)was signifi-cantly increased in comparison with that in negative control group(16.2 μg/ml±9.9 gg/ml,P<0.05)and that in bacterial pneumonia group(6.2 μg/ml±5.6 μg/ml,P<0.001).We also found that the rela-tive content of SP-D was significantly higher in PCP(24 249±4 780 grey values)than that in both nega-tive control(13 384±2 887 grey values,P<0.001)and bacterial pneumonia group(11 989±2 750 grey values,P<0.001).SP-A and SP-D were also higher in moderate to severe group of PCP than those seen in mild group(P<0.01,P<0.001).Conclusion There was obvious increase of SP-A and SP-D in PCP rats,and particularly,the change of which was greater than that in bacterial pneumonia.Therefore,the alteration of SP-A and SP-D may be of implication in the prevention and management of PCP.

ObjectiveTo predict the opportunity of infection and evaluate the severity of illness and prognosis for patients with lower resp iratory tract infections in intensive care unit (ICU) using the acute physiology and chronic health evaluation Ⅲ (APACHEⅢ) MethodsThe clini cal data of 115 cases with infections of pseudomonas aeruginosa (PA) in lowe r respiratory tract and 116 cases without PA infections were analyzed and evalua ted with APACHEⅢ score system ResultsAPACHEⅢ scores of non -survivors were significantly higher than those of survivors [(55 29?15 83) vs (25 97?14 39),P

Objective To establish the model of invasive pulmonary aspergillosis (IPA) and assay the influence on the host defense against Aspergillus infection when immunity was suppressed in mice.Methods Immunocompromised mice were made by treatment with cyclophosphamide administered intraperitoneally (i.p.).Suspension of conidia was applied to the nostrils of mice to make the model of IPA.Lungs were harvested and homogenized.Portions of homogenates were cultured to determine the number of CFU.IFN-? in bronchoalveolar lavage fluid was determined by a cytokine-specific ELISA kit.Reverse transcription PCR (RT-PCR) analysis was done to determine the mRNA of IFN-? in lung cells.Mortality of different rice was calculated.Results Compared with immunocompetent mice,the immunocompromised mice demonstrated a high mortality and had significantly higher concentration of infectious Aspergillus organisms in their lung tissues.In accordance with the increase of Aspergillus organisms,the levels of IFN-? in lung tissues got higher.Lung sections from immunocompromised mice revealed patterns of lesions characterized by signs of bronchial wall damage,peribronchial necrosis,and the presence of numerous infiltrating inflammatory cells.Conidia and hyphae were seen in these mice.In contrast,these features were not observed in immunocompetent mice whose lungs were characterized by few inflammatory cells infiltration,and few fungal growth after inoculation.Conclusion The levels of IFN-? in lung tissues are related to the infectious Aspergillus organisms.The immunity and T cells play a major role in host defense against Aspergillus infection.