Short-course therapy of acute bacterial exacerbation of chronic bronchitis: a double-blind, randomized, multicenter comparison of extended-release versus immediate-release clarithromycin.

Abstract

OBJECTIVE:

The objective of this study was to compare the efficacy and safety of two clarithromycin formulations given for 5 days to patients with acute bacterial exacerbation of chronic bronchitis (ABECB).

PATIENTS AND METHODS:

This was a double-blind, randomized, multicenter study of ambulatory patients between 40 and 75 years of age with a medical history of chronic bronchitis, chronic obstructive pulmonary disease and a presumptive diagnosis of ABECB who met Anthonisen Type 1 criteria (increased dyspnea, increased sputum volume and increased sputum purulence). Eligible patients received a 5-day course of clarithromycin extended-release (ER) 500 mg once daily or clarithromycin immediate-release (IR) 250 mg twice daily. Clinical cure, bacteriological cure and pathogen eradication rates were determined at the end of therapy and at a follow-up visit.

RESULTS:

Clinical cure rates were similar at the test-of-cure visit for evaluable patients in the clarithromycin ER group (97%, 298/307) and clarithromycin IR group (98%, 300/307) (95% CI (-3.2, 1.9)). The bacteriological cure rate was 89% and the pathogen eradication rate was 90% in both treatment groups. Resolution or improvement in cough, sputum production, sputum volume and sputum appearance was observed in > 90% of evaluable patients in each treatment group. The incidence of study drug-related adverse events was 6.6% (23/351) in the clarithromycin ER group and 5.4% (19/352) in the clarithromycin IR group. The most frequently occurring study drug-related adverse events were abdominal pain, diarrhea and taste perversion.

CONCLUSION:

Clarithromycin ER 500 mg once daily for 5 days is equivalent to clarithromycin IR 250 mg twice daily for 5 days in treating adults with ABECB. Both regimens were effective in resolving clinical signs and symptoms of ABECB and eradicating the target pathogens, and were well tolerated.

• Authors: Piotr Nalepa, Malgorzata Dobryniewska, Todd Busman, Gerard Notario
• Journal: Current medical research and opinion (Curr Med Res Opin) Vol. 19 Issue 5 Pg. 411-20 ( 2003) ISSN: 0300-7995 [Print] England
• PMID: 13678478 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Delayed-Action Preparations
• Clarithromycin

Topics

• Acute Disease
• Adult
• Aged
• Analysis of Variance
• Anti-Bacterial Agents (administration & dosage, pharmacology)
• Bacterial Infections (drug therapy, microbiology)
• Bronchitis, Chronic (drug therapy, microbiology)
• Clarithromycin (administration & dosage, pharmacology)
• Delayed-Action Preparations
• Double-Blind Method
• Drug Resistance, Bacterial
• Humans
• Middle Aged
• Patient Compliance
• Treatment Outcome