Clinical outcomes of ambulatory acute exacerbations of chronic bronchitis with older versus newer antimicrobials.
OBJECTIVE
To determine whether the cure rate was similar between traditional and newer antibiotics in the treatment of acute exacerbations of chronic bronchitis (AECB), to determine whether antibiotic selection during the first AECB of the season influences the frequency of subsequent AECB, and to identify variables associated with poor short- and long-term treatment outcome.


METHODS
A retrospective analysis of subjects seen for management of their first seasonal AECB was conducted. Subjects were stratified into traditional therapies (n = 95) or newer therapies (n = 101) by antibiotic prescription.


RESULTS
There was no difference in initial cure rates between older versus newer antibiotics (93% vs. 95%; p = 0.48). There was no difference in the number of subjects that remained AECB-free for 6 months after initial treatment with older versus newer antibiotic regimens (34% vs. 28%; p = 0.37). Oxygen initiation or increased dose (OR 10.9; 95% CI 1.4 to 84.2; p = 0.02) was the only variable independently associated with lack of AECB resolution. Nonsmoking status trended toward an association with remaining AECB-free at 180 days (OR 0.39; 95% CI 0.15 to 1.01; p = 0.053).


CONCLUSIONS
The use of older versus newer antibiotics did not independently predict short-term outcome or future AECB.
Madaras-Kelly
Karl J
KJ
Department of Pharmacy Practice, College of Pharmacy, Idaho State University, Boise 83702-4598, USA. kmk@otc.isu.edu
Magdanz
Stephanie B
SB
Johnson
Christopher K
CK
Jue
Sandra G
SG
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D029481:Bronchitis, Chronic / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D010100:Oxygen