The Appropriateness of the South African Thoracic Society's Guidelines for Antibiotic Treatment of Patients with Chronic Obstructive Pulmonary Disease Exacerbation in the Universitas Academic Hospital; Bloemfontein

Chronic obstructive pulmonary disease (COPD) is a progressive disease predominantly associated with smoking. Exacerbation of COPD frequently results from respiratory infections. The South African Thoracic Society (SATS) recommends treatment with amoxicillin/ clavulanate; cefuroxime or a fluoroquinolone. The study aimed to determine the appropriateness of these guidelines regarding organisms isolated from sputum of patients with COPD exacerbation at Universitas Academic Hospital; Bloemfontein. A descriptive study was performed. Seventeen hospitalised patients diagnosed with COPD exacerbation from July - October 2007; not treated with antibiotics or corticosteroids or having a respiratory infection four weeks prior to admission; were included. Demographic information (age; gender; area of residence; smoking history) was obtained from patients' files; as well as FEV1 values; FEV1/FVC ratio; infection markers; microorganisms isolated from sputum and their antibiotic susceptibility profiles. Nine patients were male and eight female; with a median age of 72 years (range 53 - 82 years). Twelve (70.6) patients resided in the Bloemfontein urban area. Three patients (18.8) never smoked; 25smoked previously and 56.3were active smokers (median pack years 45 years; range 17 - 70 years). Eight patients had culture-positive sputum specimens. Haemophilus influenzae; H. parainfluenzae; Streptococcus pneumoniae; Staphylococcus aureus; Pseudomonas aeruginosa; Serratia marcescens and Escherichia coli were isolated from sputa. With the exception of S. aureus; all isolates were susceptible to at least one antibiotic recommended by SATS. The guidelines proposed by SATS for treatment of COPD exacerbation were appropriate and would be effective in the management of these patients in the Free State region

Changes in Neutrophil Count; Creatine Kinases and Muscle Soreness after Repeated Bouts of Downhill Running

OBJECTIVE. A primary objective was to examine circulating neutrophil count after repeated bouts of downhill running. An additional aim was to determine creatine kinase (CK)levels during the initial 12 hours; after repeated DHRs. DESIGN. Eleven healthy; untrained Caucasian males performed 2 x 60 min bouts of DHR (-13.5); spaced 14 days apart; at a speed equal to 75VO2max on a level grade. Blood was collected before; after; and every hour for 12 hours; and every 24 hours for 6 days. Absolute neutrophil count; CK; and delayed-onset muscle soreness (DOMS) were assessed. Result were analysed using repeated measures ANOVA (p0.05) with appropriate post hoc tests. RESULT. There were no significant differences in neutrophil count (p