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1. Epithelial Lining Fluid (ELF) is major site of infection in pneumonia and other LRTI .
2. Epithelial Lining Fluid (ELF) – It is present in the Inner layer of epithelium layer of Alveoli, It is a
complex mixture having WBC’s & Anti-Inflammatory properties …which provide protective
mechanism to alveoli & improves defense for Lower respiratory tract.
In comparision to Amox + Clav, Cefuroxime, Ciprofloxacin, Levofloxacin, Clarithromycin is the only
antibiotic that achieves ELF concentration that far exceed its serum concentrations within 6 hours of
intake thereby leading to faster therapeutic effect in LRTI.
4. Biofilm:
A biofilm is a self-developed matrix produced by the bacteria, which provides protection from Host defense mechanism, facilitate attachment &
also aid in trapping nutrients.
One potential reason for this increased resistance is the penetration barrier that biofilms may present to antimicrobials.
This ensures multiplication of bacteria within the safe environment provided by this film and slowly the colony increases in size.
These Biofilms provide safe shelter to other free flowing bacteria and protect them from commonly used antibiotics.
These Biofilm forming bacteria release inflammatory mediators such as cytokines, which bring about the inflammation of epithelial cells.
Biofilm is responsible for several chronic diseases that are difficult to treat like
Chronic sinusitis
Chronic bronchitis
Pneumonias
Upper respiratory tract Infections
Rhinitis (common cold)
Sinusitis (sinus infections)
Acute Otitis Media (ear Infections)
Acute laryngitis
Acute Pharyngitis
Tonsillitis
Typical pathogens causes upto 70% cases of CAP
o Streptococcus pneumoniae
o Haemophilus influenza
o Moraxella catarrhalis
Azithromycin Clarithromycin
Drug class Macrolide antibiotic Macrolide antibiotic
Exhibits Good Antipneumolysin effect - It is a potent
Antipneumolytic activity is low - Inhibited the
macrolide which inhibits Pneumolysin by inhibiting protein
production of Pneumolysin to 330 units / ml
synthesis …Inhibited the production of Pneumolysin to 150
ONLY
units / ml
Spectrum of
activity
Demonstrates high concentration in the ELF (Epithelial lining
Demonstrates LOW concentration in the ELF
fluid in the lungs) is an important parameter of efficacy in
(Epithelial lining fluid in the lungs) is an
LRTIs.
important parameter of efficacy in LRTIs.
MIC - .063
MIC MIC - .25