Moraxella catarrhalis Infection Medication

Updated: Jul 11, 2017
  • Author: Michael Constantinescu, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Medication

Medication Summary

Various antimicrobial drugs may be used to treat Moraxella catarrhalis infection. Therapy should cover likely pathogens in the context of this clinical setting. Nearly all M catarrhalis strains produce beta-lactamase.

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Antimicrobials

Class Summary

Amoxicillin-clavulanate, second- and third-generation oral cephalosporins, and trimethoprim-sulfamethoxazole (TMP-SMZ) are the most recommended agents. Alternatively, azithromycin or clarithromycin can be used. All other agents listed below are also effective.

Erythromycin (E.E.S., Erythrocin, Ery-Tab)

Erythromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. It has the added advantage of exerting good anti-inflammatory activity by inhibiting migration of polymorphonuclear leukocytes (PMNs) Erythromycin is used for treatment of staphylococcal and streptococcal infections.

The recommended dosing schedule of erythromycin may result in gastrointestinal (GI) upset, warranting a switch to an alternative macrolide or to thrice-daily dosing. This agent covers most potential etiologic agents, including Mycoplasma species.

Although a 10-day treatment course seems to be standard, treating until the patient has been afebrile for 3-5 days seems a more rational approach. In children, age, weight, and severity of infection determine proper dosage. When twice-daily dosing is desired, half of the total daily dose may be taken every 12 hours. For more severe infections, double the dose.

Azithromycin (Zithromax, Zmax)

Azithromycin treats mild-to-moderate microbial infections.

Clarithromycin (Biaxin, Biaxin XL)

Clarithromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

Cefaclor

Cefaclor is a second-generation cephalosporin indicated for infections caused by susceptible gram-positive cocci and gram-negative rods. Determine the proper dosage and route on the basis of the condition of the patient, severity of the infection, and susceptibility of the causative organism.

Cefprozil

Cefprozil binds to 1 or more of the penicillin-binding proteins (PBPs), thereby inhibiting cell-wall synthesis and resulting in bactericidal activity.

Cefuroxime (Ceftin, Zinacef)

Cefuroxime is a second-generation cephalosporin that maintains the gram-positive activity of the first-generation cephalosporins while adding activity against Proteus mirabilis, H influenzae, Escherichia coli, Klebsiella pneumoniae, and M catarrhalis. The condition of the patient, severity of the infection, and susceptibility of the microorganism determine the proper dose.

Trimethoprim-sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

TMP-SMX inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid. Its antibacterial activity includes common urinary tract pathogens, except Pseudomonas aeruginosa.

Cefotaxime (Claforan)

Cefotaxime is used for treatment of bloodstream infection and gynecologic infections caused by susceptible organisms. It arrests bacterial cell wall synthesis, thereby inhibiting bacterial growth. It is a third-generation cephalosporin with a gram-negative spectrum; it is less efficacious against gram-positive organisms.

Ceftriaxone (Rocephin)

Ceftriaxone is a third-generation cephalosporin with broad-spectrum gram-negative activity; it has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms. It arrests bacterial growth by binding to 1 or more PBPs.

Ceftazidime (Tazicef, Fortaz)

Ceftazidime is a third-generation cephalosporin with broad-spectrum gram-negative activity; it has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms. Ceftazidime arrests bacterial growth by binding to 1 or more PBPs. Its gram-negative spectrum includes M catarrhalis. Dosage depends on the severity of infection and the susceptibility of the organism.

Ciprofloxacin (Cipro)

Ciprofloxacin is a fluoroquinolone with activity against most gram-negative organisms but no activity against anaerobes. It inhibits bacterial DNA synthesis and consequently growth.

Levofloxacin (Levaquin)

Levofloxacin is used for pseudomonal infections and infections due to multidrug-resistant gram-negative organisms.

Moxifloxacin (Avelox)

Moxifloxacin inhibits the A subunits of DNA gyrase, resulting in inhibition of bacterial DNA replication and transcription.

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