In Japan, long-term 14-membered @entity7646 administration is chosen as a first line therapy against @entity1729 ( @entity1729 ) such as @entity11592 , @entity4595 and chronic @entity3617 . However, sometimes acute exacerbations occur in these cases, even if therapy is effective. We investigated 18 episodes of @entity1729 exacerbations that were caused by @entity328 during long-term macrolides therapy from 1991 to 1999 to clarify the clinical features and prevalence of antimicrobial resistance in @entity2260 . Exacerbations did not occur only in winter season, but also in other seasons. Among 18 episodes of exacerbation, only 7 episodes (39%) revealed infiltration in chest roentogenogram and few episodes revealed marked elevations of @entity32 markers in laboratory data. Intermediate resistance or resistance rates of @entity2260 isolated from sputum or transtracheal aspiration were 100% to @entity2929 , 67% to @entity3402 or @entity1214 , 11% to @entity869 , and 0% to @entity12706 or @entity2892 . Coresistance to @entity2929 , @entity3402 and @entity1214 was seen in a half of the episodes. Resistance was not correlated with the duration of @entity7187 administration. All episodes were mainly treated with @entity3405 agents or @entity2887 and cured successfully. These findings suggest that acute exacerbations in @entity1729 caused by @entity2260 during long-term macrolides therapy do not reveal severe clinical aspects and can be treated successfully at present, but attention should be paid to the trend of antibiotic susceptibility in @entity2260 .

[Acute exacerbations due to @entity328 in XXXX during long-term macrolide therapy].

@entity3617 :: ('MESH:D001991', 'Disease') :: ['bronchitis'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity1214 :: ('MESH:D008911', 'Chemical') :: ['minocycline'] @entity2892 :: ('MESH:D015378', 'Chemical') :: ['imipenem'] @entity7646 :: ('CHEBI:25106', 'Chemical') :: ['macrolide'] @entity3405 :: ('CHEBI:35627', 'Chemical') :: ['beta-lactam'] @entity2260 :: ('2104', 'Species') :: ['S. pneumoniae'] @entity2929 :: ('MESH:D004917', 'Chemical') :: ['erythromycin'] @entity12706 :: ('CHEBI:474053', 'Chemical') :: ['cephazoline'] @entity2887 :: ('MESH:D024841', 'Chemical') :: ['fluoroquinolones'] @entity4595 :: ('MESH:D001987', 'Disease') :: ['bronchiectasis'] @entity1729 :: ('MESH:D012141', 'Disease') :: ['chronic lower respiratory tract infections', 'CLRTIs'] @entity869 :: ('MESH:D000667', 'Chemical') :: ['ampicillin'] @entity7187 :: ('MESH:D018942', 'Chemical') :: ['macrolides'] @entity11592 :: ('MESH:C536174', 'Disease') :: ['diffuse panbronchiolitis'] @entity328 :: ('1313', 'Species') :: ['Streptococcus pneumoniae'] @entity3402 :: ('MESH:D002981', 'Chemical') :: ['clindamycin']
@entity1729 :: (MESH:D012141,Disease) :: ['chronic lower respiratory tract infections']
