Amoxycillin/clavulanate in acute purulent exacerbations of chronic bronchitis.
Twenty patients, all admitted to hospital with acute purulent exacerbations of chronic bronchitis associated with Haemophilus influenzae, Streptococcus pneumoniae or beta-lactamase producing Branhamella catarrhalis were treated twice daily for ten days with amoxycillin/clavulanate. Ten patients were first given 1000 mg amoxycillin with 200 mg potassium clavulanate intravenously bd for three days, before crossing to the standard oral regimen of 1000 mg amoxycillin + 250 mg potassium clavulanate bd. Clinical results on day 10 were excellent in 16/20 patients, but 14 patients developed recurrences or reinfections within a week of the end-of-treatment, five of them with beta-lactamase producing B. catarrhalis. Bacteriological and kinetic studies showed that the branhamella beta-lactamases were inhibited by 0.25 mg/l clavulanic acid and that the mean sputum concentration of clavulanic acid was 0.16 mg/l, that of amoxycillin being 0.92 mg/l. The importance of the follow-up of such infections is stressed.
D000368:Aged; D000658:Amoxicillin / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D019980:Amoxicillin-Potassium Clavulanate Combination; D001424:Bacterial Infections / Q000188:drug therapy*; D001991:Bronchitis / Q000188:drug therapy*; D002908:Chronic Disease; D002969:Clavulanic Acids / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D004338:Drug Combinations / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy*; D006193:Haemophilus influenzae / Q000187:drug effects; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009016:Moraxella / Q000187:drug effects / Q000201:enzymology; D012008:Recurrence; D013183:Sputum / Q000378:metabolism / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy*; D013296:Streptococcus pneumoniae / Q000187:drug effects; D065093:beta-Lactamase Inhibitors
D002969:Clavulanic Acids; D004338:Drug Combinations; D065093:beta-Lactamase Inhibitors; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin