Comparative study of cefaclor AF vs. cefuroxime axetil in acute exacerbations of chronic bronchitis.
BACKGROUND
Acute exacerbations of chronic bronchitis (AECB) are the most common complication of chronic bronchitis. The majority of AECB are caused by infection. The choice of appropriate antibacterial therapy for AECB is becoming more difficult and is usually empirically. Cefaclor and cefuroxime are used for ambulatory treatment of AECB.


METHODS
This multicenter, randomized, single blind study was undertaken in order to compare efficacy and safety of cefaclor AF (500 mg BID) and cefuroxime axetil (250 mg BID) in 10 days treatment of ambulatory patients with AECB. 170 adults were enrolled into the study. Clinical responses were assessed on 17th-24th day after randomization.


RESULTS
Both antibiotics had high over 97% effectiveness in the treatment of AECB. There was statistically significant 1.7 times higher rate of patients with cough release after cefaclor treatment compared to cefuroxime (p<0.03). There was a significantly 2.25 higher rate of patients with AECB symptoms release like: increasing dyspnea, sputum volume and sputum purulence or cough in cefaclor group compared to cefuroxime (p<0.0187). Both treatments resulted in significant improvement of pulmonary peak expiratory flow (PEF). There were no differences between the rates of gastrointestinal and other side effects in both groups.


CONCLUSIONS
1. Cefaclor and cefuroxime have similar high efficacy and safety in 10 days treatment of patients with AECB. 2. Cefaclor treatment significantly higher 2.25 times reduces the rate of principle symptoms of AECB compared to cefuroxime. 3. Both antibiotics treatment significantly increase PEF, with higher tendency observed in after cefaclor treatment.
Haczyński
Józef
J
Medical Department Eli Lilly Polska, Warsaw, Poland. Haczynski_jozef@lilly.com
Chyczewska
Elzbieta
E
Grzelewska-Rzymowska
Iwona
I
Malolepszy
Józef
J
Marcinkowska-Suchowierska
Ewa
E
Milanowski
Janusz
J
Oklek
Kazimierz
K
Płusa
Tadeusz
T
Słominski
Jan
J
Szmygin
Katarzyna
K
Rek
Miroslaw
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D029481:Bronchitis, Chronic / Q000188:drug therapy*; D002433:Cefaclor / Q000627:therapeutic use*; D002444:Cefuroxime / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
D002511:Cephalosporins; D002433:Cefaclor; D002444:Cefuroxime; C040738:cefuroxime axetil