Use of quinolones for the treatment of acute exacerbations of chronic bronchitis

Chodosh, Sanford

doi:10.1016/0002-9343(91)90318-r

Cited by 19 publications

(6 citation statements)

References 30 publications

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“…It is more active than amoxicillin against the major respiratory pathogens, H. influenzae and M. catarrhalis, and other gram-negative organisms but less active against S. pneumoniae (31). This finding has been observed with other quinolones (7).…”

supporting

confidence: 86%

Double-blind, comparative study of rufloxacin once daily versus amoxicillin three times a day in treatment of outpatients with exacerbations of chronic bronchitis

Klietmann¹,

Cesana²,

Rondel³

et al. 1993

Antimicrob Agents Chemother

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In a double-blind, randomized, multicenter study, the efficacy and safety of two dosage schedules of rufloxacin once daily were compared with those of amoxicillin three times a day in the treatment of 192 outpatients with exacerbations of chronic bronchitis. Rufloxacin was given as a single oral dose of 400 mg on day 1 and single daily doses of 200 mg on the subsequent 9 days (n = 64) or as 300 mg on day 1 and then 150 mg daily for 9 days (n = 63); amoxicillin was given as 500 mg orally three times a day for 10 days (n = 65).Clinical and bacteriological assessments were carried out before treatment, between study days 3 and 5, and at days 1 and 8 after treatment. Pretreatment cultures were positive for 139 patients, the most frequently isolated pathogens being Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae.Clinical success rates were comparable in the three groups (94, 95, and 98%, respectively), as were bacteriological success rates at the end of treatment (93, 95, and 91%, respectively) and at follow-up (88, 95, and 98%, respectively). The power to detect a significant 15% difference in cure rates was 74.9%k. Follow-up bacteriological failures from pneumococcal infection were 18% in both rufloxacin groups combined and 5% in the amoxicillin group. The 200-mg dose regimen achieved average steady-state concentrations in plasma higher than did the 150-mg dose regimen (3.75 versus 2.72 ag/ml). Adverse events occurred in 11 and 13 patients, respectively, on rufloxacin and 8 on amoxicillin. This study shows that rufloxacin once daily may be a possible option for the treatment of acute exacerbations of chronic bronchitis. The 200-mg daily oral dose preceeded by a loading dose of 400 mg displays a better pharmacokinetic profile than the lower dose.Amoxicillin, a broad-spectrum antibiotic, is currently often used to treat patients with acute exacerbations of chronic bronchitis. Amoxicillin is effective against the most common potential pathogens causing this condition and has a convenient dosage and a satisfactory degree of safety. Because of the recent increase in the number ofHaemophilus influenzae and Moraxella catarrhalis ,-lactamase-producing strains (10, 28) and of penicillin-resistant Streptococcus pneumoniae strains in the etiology of these infections (21), the new-broad spectrum fluoroquinolones may be a good alternative (30).Rufloxacin is a new fluoroquinolone antibacterial agent (4) with broad bactericidal activity (24, 31) and a long elimination half-life (35 h), which allows once-daily oral administration (15, 23). It is more active than amoxicillin against the major respiratory pathogens, H. influenzae and M. catarrhalis, and other gram-negative organisms but less active against S. pneumoniae (31). This finding has been observed with other quinolones (7).Rufloxacin concentrates for a long time in respiratory sites, reaching respective concentrations in the epithelial lining fluid of the distal airways and in alveolar macrophages of 10 and 20 times those in serum, with levels l...

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supporting

confidence: 86%

Double-blind, comparative study of rufloxacin once daily versus amoxicillin three times a day in treatment of outpatients with exacerbations of chronic bronchitis

Klietmann¹,

Cesana²,

Rondel³

et al. 1993

Antimicrob Agents Chemother

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“…Ciprofloxacin (208 days to relapse) and temafloxacin (235 days) offer ratios equal to or in excess of unity when compared with ampicillin. 79 A similar approach was taken by Bennet and col-leagues53 who measured not only the time to the next exacerbation but also the number of exacerbations in the year following therapy. Alternatively, response can be assessed at a fixed interval.…”

Section: New Approaches To 0utco~e Assessmentmentioning

confidence: 99%

Epidemiology and Treatment of Chronic Bronchitis and Its Exacerbations

Ball¹

1995

Chest

214

123

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“…The The fiuoroquinolones are reported to have good to excellent activity against most common pathogens in this disease (CHODOSH 1991a). None of the isolates were resistant to ciprofioxacin.…”

Section: Acute Exacerbation Of Chronic Bronchitismentioning

confidence: 94%

Quinolone Antibacterials

1998

Handbook of Experimental Pharmacology

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Use of quinolones for the treatment of acute exacerbations of chronic bronchitis

Cited by 19 publications

References 30 publications

Double-blind, comparative study of rufloxacin once daily versus amoxicillin three times a day in treatment of outpatients with exacerbations of chronic bronchitis

Double-blind, comparative study of rufloxacin once daily versus amoxicillin three times a day in treatment of outpatients with exacerbations of chronic bronchitis

Epidemiology and Treatment of Chronic Bronchitis and Its Exacerbations

Quinolone Antibacterials

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