Bacterial pneumonia complicating adenoviral pneumonia: A comparison of respiratory tract bacterial culture sources and effectiveness of chemoprophylaxis against bacterial pneumonia

Abstract Thirty-five USAF basic trainees hospitalized with nonbacterial pneumonia during an epidemic of acute respiratory disease were treated either with tetracycline or minocycline to prevent secondary bacterial pneumonia; 15 served as untreated controls. Six of 50 patients had bacterial pneumonia, two in each of the two treatment groups and the control group. Three of four patients with bacterial pneumonia being treated with tetracycline or minocycline required additional antibiotics for recovery. Five of six patients with bacterial pneumonia had adenovirus infections. Eighteen of the 44 patients with only nonbacterial pneumonia had single or multiple infections with adenovirus, parainfluenza, influenza A 2 or B viruses. In this population, (1) adenoviral and bacterial pneumonia were associated, although a causal relationship was not proved; (2) tetracycline and minocycline were not efficacious either for preventing or treating bacterial pneumonia complicating adenoviral pneumonia; (3) group Y Neisseria meningitidis was a significant lower respiratory pathogen; and (4) bacterial culture of specimens from the respiratory tract obtained by transtracheal aspiration or transthoracic lung aspiration more accurately reflect the bacteriology of infection in the lower respiratory tract than do cultures of expectorated sputum.