[N-acetylcystein in the therapy of chronic bronchitis].
Chronic bronchitis (CB) shows an increasing global morbidity and mortality with major impact on socioeconomics. N-Acetylcysteine (NAC), previously used as a mucolytic compound in CB, has also antioxidative effects. Furthermore it influences intrabronchial bacterial colonisation. In a randomised pilot study of 24 patients (16-male, 8 female, mean age 66 +/- 10 years) with acute exacerbation of CB and positive bacterial culture in the sputum, the addition of twice daily 600 mg NAC to standard antibiotic therapy lead to a significantly higher bacterial eradication rate (70 % versus 36 %, p < 0.03). Clinical studies suggest that treatment with NAC has different effects in CB including a reduction of the number and duration of acute exacerbation episodes and possibly influences lung function. The improvement of symptoms and quality of life also has an impact on socio-economic costs. The use of NAC in CB as an antioxidative rather than a mucolytic compound should be considered. However, further placebo controlled studies are undergoing to definitively establish the role of NAC for the treatment of CB and COPD.
Reichenberger
F
F
Pneumologie, Departement Innere Medizin, Universitätskliniken Basel, Schweiz, Germany.
Tamm
M
M
D000111:Acetylcysteine / Q000627:therapeutic use*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D001991:Bronchitis / Q000188:drug therapy*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005100:Expectorants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000975:Antioxidants; D005100:Expectorants; D000111:Acetylcysteine