EFFICACY AND TOLERABILITY OF AZITHROMYCIN VERSUS AMOXICILLIN/CLAVULANIC ACID IN ACUTE PURULENT EXACERBATION OF CHRONIC-BRONCHITIS

被引：42

作者：

BEGHI, G ^{[1
]}

BERNI, F ^{[1
]}

CARRATU, L ^{[1
]}

CASALINI, A ^{[1
]}

CONSIGLI, G ^{[1
]}

DANTO, M ^{[1
]}

GIOIA, V ^{[1
]}

MOLINO, A ^{[1
]}

PAIZIS, G ^{[1
]}

VAGHI, A ^{[1
]}

机构：

[1] S CORONA HOSP,DEPT PNEUMOL,MILAN,ITALY

来源：

JOURNAL OF CHEMOTHERAPY | 1995年 / 7卷 / 02期

关键词：

AMOXICILLIN/CLAVULANIC ACID; BETA-LACTAM; BETA-LACTAMASE INHIBITOR; AZITHROMYCIN; AZALIDE; EXACERBATION OF CHRONIC BRONCHITIS; ANTIBIOTICS; SAFETY; TOLERANCE; LOWER RESPIRATORY TRACT INFECTIONS;

D O I：

10.1179/joc.1995.7.2.146

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

An open randomized trial was conducted in 142 hospitalized and out-patients with acute purulent exacerbation of chronic bronchitis to compare the clinical efficacy and tolerability of azithromycin (n = 69) and amoxicillin/clavulanic acid (n = 73). Azithromycin (500 mg) was administered as a single dose for three days and amoxicillin I clavulanic acid (amoxicillin 875 mg - clavulanic acid 125 mg) was given b.i.d. for 8 days (8.16 +/- 1.18). Before therapy and 24-48 hours after the end of treatment, sputum culture (by positioning five orthodontal swabs at the opening of salivary gland ducts after a washing of the oral cavity with sterile saline solution to avoid oral contamination), chest X-rays, arterial blood gas analysis, trials of respiratory functions and routine blood tests were performed. In the azithromycin group (69 patients) the efficacy rate was 67.6% (46 patients: 34 cured and 12 improved); in 22 patients (32.4%) the treatment failed; 1 patient was not evaluated because of no follow-up, The overall efficacy rate in the amoxicillin/clavulanic acid group (73 patients) was 97.3% (71 patients: 60 cured and 11 improved); in 1 patient (1.4%) the treatment failed and 1 patient was a drop-out for side effects. All pathogens isolated before treatment were susceptible to the antibiotics administered. At the end of treatment microbiological efficacy was 67.1% in the azithromycin group and 98.6% in the amoxicillin/clavulanic acid group. The tolerability was judged good in both treatment groups. Side effects were observed in 1 patient treated with amoxicillin/clavulanic acid (diarrhea), which imposed interruption of treatment, and in 2 patients from the azithromycin group (gastralgia and biochemical laboratory tests: renal function). These data suggest that the efficacy of amoxicillin/clavulanic acid in the treatment of bacterial exacerbation of chronic bronchitis is higher than that of azithromycin; this new azalide appears to be inadequate for the treatment of this pathology.

引用

页码：146 / 152

页数：7

共 28 条

[1] Riechek N., Lewin E.G., Rhoden D., Et al., Antibody responses to bacterial antigens during exacerbations of chronic bronchitis, Am Rev Resp Dis, 101, pp. 238-244, (1970)
[2] Stenhouse A.C., Rinovirus infection in acute exacerbations of chronic bronchitis: A controlled prospective study, Br Med J, 3, pp. 461-463, (1967)
[3] Anthonisen N.R., Manfreda J., Warren C., Hershfield E.S., Harding G., Nelson N.A., Antibiotic therapy in exacerbations of chronic bronchitis, Ann Intern Med, 106, pp. 196-204, (1987)
[4] Legnani D., Bronchite cronica e l’asma bronchiale: Le sovrainfezioni, Giorn Ital Mal Torace, 45, pp. 271-274, (1991)
[5] Hoepelman A., Sips A.P., Van Helmond J., Et al., A single-blind comparison of a three-day azithromycin and ten- day co-amoxiclav treatment of acute and lower respiratory tract infections, J Antimicrob Chemother, 31, pp. 147-152, (1993)
[6] Bradbury F., Comparison of azithromycin versus clarithromycin in the treatment of patients with lower respiratory tract infections, J Antimicrob Chemother, 31, pp. 153-162, (1993)
[7] Balmes P., Clerc G., Dupont B., Labram C., Pariente R., Poirier R., Comparative study of azithromycin and amoxi- cillin/clavulanic acid in the treatment of lower respiratory tract infections, Eur J Clin Microbiol Infect Dis, 31, pp. 437-439, (1991)
[8] Dark D., Multicenter evaluation of azithromycin and cefaclor in acute lower respiratory infections, Am J Med, 91, pp. 31S-35S, (1991)
[9] Barsic B., Schonwald S., Sagud M., Klinar I., Three days azithromycin versus ten days of cefaclor in treatment of bacterial lower respiratory tract infections, Recent Advances in Chemother. Proceedings 18Th Intern. Congr. Chemother. Stockholm 1993
[10] 27/06-02/07, pp. 24-25, (1994)

← 1 2 3 →