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A five-day course of dirithromycin in the treatment of acute exacerbation of severe chronic obstructive pulmonary disease.

Abstract
Since dirithromycin persists at high concentrations in the lung for at least 3 days following the last dose of a 5-day course, we evaluated the clinical efficacy and tolerance of a 5-day course of dirithromycin in 20 patients with acute exacerbation of severe chronic obstructive pulmonary disease, treated with a total dose of 2.5 g dirithromycin (500 mg once-daily for 5 days) in an open, non-comparative study. Patients were assessed before therapy and after 5 (last administration), 10 (post-therapy) and 20 (late post-therapy) days. Pathogen elimination or presumed elimination was seen in 18/20 patients at the post-therapy visit and at the late post-therapy visit, but two Haemophilus influenzae out 5 were isolated in sputum after 10 days and only one after 20 days (Pseudomonas aeruginosa was the other pathogen). Dirithromycin was well-tolerated and only 2 patients reported mild gastrointestinal pain. This study shows that a 5-day dirithromycin therapy provides a convenient and efficient dosage regimen in acute exacerbation of chronic bronchitis. Notwithstanding its poor in vitro activity against H. influenzae, dirithromycin was fairly active against this microorganism in vivo.
AuthorsM Cazzola, M Caputi, G Santangelo, A Diu Vinciguerra, F D Perna, M Polverino
JournalJournal of chemotherapy (Florence, Italy) (J Chemother) Vol. 9 Issue 4 Pg. 279-84 (Aug 1997) ISSN: 1120-009X [Print] England
PMID9269609 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Macrolides
  • dirithromycin
  • Erythromycin
Topics
  • Acute Disease
  • Administration, Oral
  • Adult
  • Aged
  • Anti-Bacterial Agents (administration & dosage, therapeutic use)
  • Erythromycin (administration & dosage, analogs & derivatives, therapeutic use)
  • Female
  • Haemophilus (isolation & purification)
  • Humans
  • Lung Diseases, Obstructive (drug therapy, physiopathology)
  • Macrolides
  • Male
  • Middle Aged
  • Spirometry
  • Sputum (microbiology)

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