A five-day course of dirithromycin in the treatment of acute exacerbation of severe chronic obstructive pulmonary disease.
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.
Cazzola
M
M
Respiratory Clinical Pharmacology Unit, A. Cardarelli Hospital, Naples.
Caputi
M
M
Santangelo
G
G
Diu Vinciguerra
A
A
Perna
F D
FD
Polverino
M
M
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004917:Erythromycin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006190:Haemophilus / Q000302:isolation & purification; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D018942:Macrolides; D008297:Male; D008875:Middle Aged; D013147:Spirometry; D013183:Sputum / Q000382:microbiology
D000900:Anti-Bacterial Agents; D018942:Macrolides; C053853:dirithromycin; D004917:Erythromycin