A comparison of 5 days of dirithromycin and 7 days of clarithromycin in acute bacterial exacerbation of chronic bronchitis.
The safety and efficacy of dirithromycin and clarithromycin were compared in a single-blind, multicentre study of patients with acute bacterial exacerbation of chronic bronchitis (AECB). Patients received either dirithromycin, 500 mg once daily for 5 days, or clarithromycin, 250 mg twice daily for 7 days. A total of 212 patients entered the study, of whom 191 qualified for efficacy analysis. Favourable post-therapy clinical and bacteriological response rates for qualified patients (95 dirithromycin and 96 clarithromycin) were similar: 89.5% and 68.8% for dirithromycin vs 94.8% and 71.9% for clarithromycin. At late post-therapy evaluation, favourable clinical and bacteriological response rates were achieved in 98.8% and 96.2% of dirithromycin patients and 95.3% and 93.3% of clarithromycin patients, respectively. These differences were neither statistically nor clinically significantly different. Both drugs had similar efficacy against Haemophilus influenzae and both were well tolerated. Dirithromycin, administered as a single daily dose for just 5 days resulted in complete compliance in all but four patients. In clarithromycin-treated patients, requiring a 7-day course of twice-daily treatment, compliance was less satisfactory, with 12 patients failing to comply, though the between-group difference was not statistically significant. It can be concluded that 5 days of dirithromycin, 500 mg once daily is as safe and effective as 7 days of clarithromycin, 250 mg, twice daily in the treatment of AECB.
Health Centre, Sligo, Ireland.
J
J
Hosie
P
P
Quinn
P
P
Smits
G
G
Sides
D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy*; D001991:Bronchitis / Q000150:complications* / Q000188:drug therapy*; D002908:Chronic Disease; D017291:Clarithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D004917:Erythromycin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D018942:Macrolides; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D016037:Single-Blind Method
D000900:Anti-Bacterial Agents; D018942:Macrolides; C053853:dirithromycin; D004917:Erythromycin; D017291:Clarithromycin