The efficacy and safety of seven days treatment with oral
dirithromycin 500 mg given once daily was compared with oral
erythromycin 250 mg qid in patients with acute bacterial exacerbations of
chronic bronchitis. A total of 393 patients received
dirithromycin and 409
erythromycin. Of 101
dirithromycin-treated patients analysed for efficacy, 87 (86%) had favourable clinical responses compared with 72/81 (89%) of those treated with
erythromycin. Proven or presumed pathogen elimination was noted in 85/101 (84%)
dirithromycin-treated patients and 66/81 (82%)
erythromycin treated patients. Late post-
therapy responses were also similar between treatment groups. Favourable clinical responses were noted in 89% of patients treated with
dirithromycin and 91% of those receiving
erythromycin. A favourable bacteriological response was noted in 87.5% and 89.6% of the
dirithromycin- and
erythromycin-treated groups, respectively. Adverse events were also similar between treatment groups. Gastrointestinal events were the most common events in both groups of patients;
erythromycin was associated with a significantly higher incidence of diarrhoea (P = 0.003).
Dirithromycin was associated with a higher incidence of lung events (P = 0.043). It is concluded that
dirithromycin given once a day is comparable in efficacy and safety to four-times-daily
erythromycin in the treatment of acute bacterial exacerbations of
chronic bronchitis.