title: Comparative safety and efficacy of clarithromycin and ampicillin in the treatment of out-patients with acute bacterial exacerbation of chronic bronchitis.
abstract: In an open, randomized trial, adult non-hospitalized patients with acute bacterial exacerbation of chronic bronchitis were treated with 500 mg clarithromycin twice daily (n = 53) or 500 mg ampicillin four times daily (n = 50). Causative pathogens included S. pneumoniae, M. catarrhalis, H. influenzae, H. parainfluenzae and S. aureus. For clinically evaluable patients, successful outcome (cure or improvement) was noted for 53/53 (100%) clarithromycin-treated patients and 46/47 (98%) ampicillin-treated patients. Clinically significant improvement in signs and symptoms was comparable between treatment groups. There was 100% bacteriological eradication in both treatment groups. Eight patients (15%) in the clarithromycin group and 10 patients (20%) in the ampicillin group reported adverse events, the majority of which were mild or moderate in severity; six events in each treatment group were digestive-system disorders. The new macrolide, clarithromycin, appears to be effective and well-tolerated in the treatment of acute exacerbation of chronic bronchitis.
authors.affiliation: Section of Clinical Pharmacology, St Paul-Ramsey Medical Center, Minnesota.
authors.forename: D R
authors.initials: DR
authors.lastname: Guay
authors.forename: J C
authors.initials: JC
authors.lastname: Craft
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D001991:Bronchitis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D017291:Clarithromycin; D004917:Erythromycin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D004917:Erythromycin; D000667:Ampicillin; D017291:Clarithromycin