Sparfloxacin vs Ofloxacin in the Treatment of Acute Bacterial Exacerbations of Chronic Bronchitis

DeAbate, C. Andrew; Henry, Dan; Bensch, George; Jubran, Amal; Chodosh, Sanford; Harper, Lisa J.; Tipping, Diane; Talbot, George H.

doi:10.1378/chest.114.1.120

Cited by 61 publications

(10 citation statements)

References 25 publications

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“…Prevalence studies reveal that 20 to 40% of healthy children and 10 to 20% of healthy adults are colonized at any one time (108,137,221). Several longitudinal studies have established that colonization of the upper airway with S. pneumoniae is common in infants and children (74,89,92,181,255,285). Most children are colonized with the pneumococcus at some time during the first 2 years of life.…”

Section: Streptococcus Pneumoniaementioning

confidence: 99%

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

2001

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SUMMARY Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. The precise role of bacterial infection in the course and pathogenesis of COPD has been a source of controversy for decades. Chronic bacterial colonization of the lower airways contributes to airway inflammation; more research is needed to test the hypothesis that this bacterial colonization accelerates the progressive decline in lung function seen in COPD (the vicious circle hypothesis). The course of COPD is characterized by intermittent exacerbations of the disease. Studies of samples obtained by bronchoscopy with the protected specimen brush, analysis of the human immune response with appropriate immunoassays, and antibiotic trials reveal that approximately half of exacerbations are caused by bacteria. Nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae are the most common causes of exacerbations, while Chlamydia pneumoniae causes a small proportion. The role of Haemophilus parainfluenzae and gram-negative bacilli remains to be established. Recent progress in studies of the molecular mechanisms of pathogenesis of infection in the human respiratory tract and in vaccine development guided by such studies promises to lead to novel ways to treat and prevent bacterial infections in COPD.

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Section: Streptococcus Pneumoniaementioning

confidence: 99%

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

2001

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“…The known failure rates after ambulatory treatment were derived from clinical trials on antibiotics in chronic bronchitis and ranged 7-12% [30,31]. Nevertheless, these results cannot be extrapolated to everyday practice, since patients included in clinical trials consisted of chronic bronchitis patients (whatever that means) and included subjects with ages ranging 18-90 yrs, a significant proportion of which were never smokers and individuals without ventilatory impairment.…”

Section: Frequency and Outcomes Of Exacerbations: Risk Factors For Rementioning

confidence: 99%

Exacerbations of chronic obstructive pulmonary disease: when are bacteria important?

Miravitlles¹

2002

European Respiratory Journal

100

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The progressive course of chronic obstructive pulmonary disease (COPD) is often aggravated by exacerbations, the majority of them produced by bronchial infection. Frequent exacerbations have been demonstrated to have a negative impact on quality of life and pulmonary function in patients with COPD, particularly in active smokers. Furthermore, acute exacerbations are the most frequent cause of medical visits, hospital admissions and death among patients with chronic lung disease.Evidence indicates that the number of patients with pathogenic bacteria in respiratory secretions and the bronchial bacterial load increase during exacerbations. Furthermore, the local inflammatory response of the host parallels the increase in bacterial load. From these observations, it can be speculated that, for symptoms of acute exacerbation to appear, there must be a minimum bacterial load in the airways, i.e. a threshold above which the inflammatory reaction is severe enough to elicit clinical symptoms of exacerbation. This threshold may vary from patient to patient owing to different modifying factors. Some of these factors may be the recognised risk factors for relapse, such as increasing age, impairment of lung function, comorbid conditions or frequent exacerbations in the past.Relapse rates after ambulatory treatment of acute exacerbation of COPD may be as high as 20-25% of cases. Relapses are associated with significant mordibity and increased costs.A number of unanswered questions remain regarding exacerbations of chronic obstructive pulmonary disease. These include the role of viral infection, the importance of residual bacterial colonisation and the impact of new antibiotics on the treatment of exacerbations. Chronic obstructive pulmonary disease (COPD) is one of the most prevalent diseases in developed countries. Furthermore, the number of individuals affected has grown since the 1980s [1]. In Spain, the prevalence of COPD is 9% in adults aged 40-70 yrs, although only 22% of these are diagnosed [2]. Tobacco smoking is the main aetiological factor for COPD. In a population-based study in Spain, 25% of the population aged 40-70 yrs were smokers and another 25% former smokers [3]. Only 15-20% of smokers will develop COPD, and smokers with COPD exhibit higher tobacco consumption and greater dependence on nicotine than smokers who do not have COPD, and more than one-third have never tried to stop smoking [3]. These figures indicate that the problem of COPD in most developed countries will continue to increase in the near future.The chronic and progressive course of COPD is often aggravated by short periods of increasing symptoms, particularly increasing cough, dyspnoea and production of sputum which can become purulent.

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“…for 7-14 days) [60] and ofloxacin (400 mg b.i.d. for 10 days) [61]; for grepafloxacin (400 mg or 600 mg q.d. for 7-10 days) compared with ciprofloxacin (500 mg b.i.d.…”

Section: Clinical Applicationsmentioning

confidence: 99%

New Uses for New and Old Quinolones and the Challenge of Resistance

Hooper¹

2000

Clinical Infectious Diseases

151

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More than a decade ago ciprofloxacin, the first quinolone with broad indications, was released for clinical use in the United States. The release of ofloxacin, which also had broad applications, followed not long thereafter. Since that time there has been extensive use of these 2 agents and more limited use of other quinolones, such as norfloxacin, enoxacin, and lomefloxacin, which were limited to treatment of infections of the genitourinary tract. Applications of these quinolones largely employed their potent activities against gram-negative bacteria [1,2].This article focuses on information developed in the past 4 years on the 4 most recently released quinolones-levofloxacin, sparfloxacin, grepafloxacin, and trovafloxacin [3-8]-and their spectrum of activity, pharmacokinetics, tolerability, and clinical applications. It also focuses on new applications of the older quinolones. Issues of quinolone resistance related to expanding uses of quinolones will also be discussed. Spectrum of ActivityThe newer fluoroquinolones have retained much of the activity of ciprofloxacin and ofloxacin against enteric gramnegative bacteria, but none is more potent than ciprofloxacin against these pathogens or against Pseudomonas aeruginosa. Levofloxacin is the active stereoisomer of the racemic mixture of the 2 stereoisomers that make up ofloxacin and thus is generally 2-fold more potent than ofloxacin [3]. Trovafloxacin [9] and, to a lesser extent, levofloxacin generally have gram-negative coverage similar to that of ciprofloxacin, but both may be less active against some strains of P. aeruginosa.There may also be gaps in trovafloxacin's coverage of some strains of Providencia species, Proteus species, and Serratia marcescens. There are also gaps in the gram-negative coverage of sparfloxacin and grepafloxacin. Sparfloxacin [10,11] has only limited potency against P. aeruginosa, S. marcescens, Citrobacter freundii, and Proteus vulgaris; and grepafloxacin [12] lacks sufficient activity against P. aeruginosa, S. marcescens, Providencia stuartii, and Acinetobacter baumanii among gram-negative bacteria.Like ciprofloxacin and ofloxacin, the newer agents have excellent potency against genital pathogens, including Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma hominis. Their clinical efficacy in the treatment of genital chlamydial infections may differ, however, as discussed below.Against respiratory pathogens, all of the newer quinolones, such as ciprofloxacin and ofloxacin, are highly potent against Haemophilus influenzae and Moraxella catarrhalis. However, these agents exhibit greater potency than ciprofloxacin and ofloxacin against Streptococcus pneumoniae, with MIC 90 values of 1-2 mg/mL for levofloxacin [13], 0.25-0.5 mg/mL for sparfloxacin [14] and grepafloxacin [15], and 0.12-0.25 mg/mL for trovafloxacin [16]. For this reason, all have been developed for treatment of respiratory tract infections, as discussed below. Other respiratory pathogens, such as Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydia pneum...

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Sparfloxacin vs Ofloxacin in the Treatment of Acute Bacterial Exacerbations of Chronic Bronchitis

Cited by 61 publications

References 25 publications

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

Bacterial Infection in Chronic Obstructive Pulmonary Disease in 2000: a State-of-the-Art Review

Exacerbations of chronic obstructive pulmonary disease: when are bacteria important?

New Uses for New and Old Quinolones and the Challenge of Resistance

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