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Abstract [Full-Text PDF] [Macedonian Abstract] [OnlineFirst Full-Text PDF]
Macedonian Journal of Medical Sciences. 2009 Jun 15; 2(2):115-120. doi:10.3889/MJMS.1857-5773.2009.0040 Clinical Science
Efficacy and Tolerability of Various Antimicrobial Regimens in the Treatment of Exacerbations of Chronic Bronchitis and Chronic Obstructive Pulmonary Disease in Outpatients Jordan Minov1, Jovanka Karadzinska-Bislimovska1, Tatjana Petrova2, Kristin Vasilevska3, Snezana Risteska-Kuc1, Saso Stoleski1, Dragan Mijakoski1 1Institute for Occupational Health of R. Macedonia – WHO Collaborating Center and GA2LEN Collaborating Center, Skopje, Republic of Macedonia; 2Department of Pharmacy Care Systems, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, USA; 3Institute of Epidemiology and Biostatistics, Skopje, Republic of Macedonia
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.
Key words: Antibiotic; chronic bronchitis; chronic obstructive pulmonary disease; exacerbation. |
Publication of the MJMS is supported by
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Macedonian
Ministry of Education and
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Publisher: Institute of Immunobiology and Human Genetics, Skopje, Republic of Macedonia. |
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(ISSN 1857-5749) is an international peer-reviewed, Open
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