Efficacy and Tolerability of Various Antimicrobial Regimens in the Treatment of Exacerbations of Chronic Bronchitis and Chronic Obstructive Pulmonary Disease in Outpatients
Journal
Macedonian Journal of Medical Sciences
Date Issued
2009-06-01
Author(s)
Petrova, Tatjana
Risteska-Kuc, Snezana
Abstract
Objective. To compare the efficacy and tolerability of different antibiotics empirically
administered for exacerbations of chronic bronchitis and chronic obstructive
pulmonary disease (COPD).
Methods. We performed an observational, non-randomized, open-label study
including 226 outpatients with exacerbations of chronic bronchitis and mild or
moderate COPD, 123 males and 103 females, aged 24 to 81. All patients were
followed up for 30 days, with an intermediate visits at 5 and 10 days at which they
were asked about the duration of symptoms (increased expectoration, increased
dyspnea and/or presence of purulent sputum) and the side-effects of the drug. Five
antibiotic regimens were evaluated: amoxicillin/clavulanic acid 875 mg/125 mg
twice daily for 10 days, cefuroxime 250 mg twice daily for 10 days, cefixime 400 mg
once daily for 10 days, clarithromycin 500 mg twice daily for 10 days, and ciprofloxacin
500 mg twice daily for 10 days.
Results. The clinical success rate, defined as a complete resolution or a return of
the symptoms to the baseline severity, in the groups receiving amoxicillin/clavulanic
acid, cefuroxime, cefixime, clarithromycin, and ciprofloxacin was 68.9%, 75.0%,
73.5%, 72.7%, and 77.1%, respectively. The mean time to relief of symptoms varied
from 6.8 days with amoxicillin/clavulanic acid to 6.1 days with cefuroxime. Relapse
within the first month was registered in the group receiving clarithromycin and
ciprofloxacin (3.1% and 2.6%, respectively). The prevalence of the adverse events
varied from 10.4% with ciprofloxacin, following by 8.9% for amoxicillin/clavulanic
acid, 7.5% for cefixime, 6.8% with clarithromycin to 6.1% with cefuroxime.
Conclusion. Our findings suggest high efficacy and safety of all studied regimens
in the treatment of exacerbations of chronic bronchitis and COPD.
administered for exacerbations of chronic bronchitis and chronic obstructive
pulmonary disease (COPD).
Methods. We performed an observational, non-randomized, open-label study
including 226 outpatients with exacerbations of chronic bronchitis and mild or
moderate COPD, 123 males and 103 females, aged 24 to 81. All patients were
followed up for 30 days, with an intermediate visits at 5 and 10 days at which they
were asked about the duration of symptoms (increased expectoration, increased
dyspnea and/or presence of purulent sputum) and the side-effects of the drug. Five
antibiotic regimens were evaluated: amoxicillin/clavulanic acid 875 mg/125 mg
twice daily for 10 days, cefuroxime 250 mg twice daily for 10 days, cefixime 400 mg
once daily for 10 days, clarithromycin 500 mg twice daily for 10 days, and ciprofloxacin
500 mg twice daily for 10 days.
Results. The clinical success rate, defined as a complete resolution or a return of
the symptoms to the baseline severity, in the groups receiving amoxicillin/clavulanic
acid, cefuroxime, cefixime, clarithromycin, and ciprofloxacin was 68.9%, 75.0%,
73.5%, 72.7%, and 77.1%, respectively. The mean time to relief of symptoms varied
from 6.8 days with amoxicillin/clavulanic acid to 6.1 days with cefuroxime. Relapse
within the first month was registered in the group receiving clarithromycin and
ciprofloxacin (3.1% and 2.6%, respectively). The prevalence of the adverse events
varied from 10.4% with ciprofloxacin, following by 8.9% for amoxicillin/clavulanic
acid, 7.5% for cefixime, 6.8% with clarithromycin to 6.1% with cefuroxime.
Conclusion. Our findings suggest high efficacy and safety of all studied regimens
in the treatment of exacerbations of chronic bronchitis and COPD.
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