title: Efficacy and safety of azithromycin vs levofloxacin in the outpatient treatment of acute bacterial exacerbations of chronic bronchitis.
abstract: OBJECTIVE
  To compare the safety and efficacy of oral azithromycin and levofloxacin in the treatment of outpatients with acute bacterial exacerbations of chronic bronchitis (ABECB).
  
  
  METHODS
  Randomized, double-blinded, double-dummy, multicenter trial with 1:1 treatment allocation.
  
  
  METHODS
  Outpatient treatment setting.
  
  
  METHODS
  Two hundred thirty-five male or female outpatients between the ages of 35 and 75 years who had received a clinical diagnosis of ABECB.
  
  
  METHODS
  Blinded treatment with either oral azithromycin, 500 mg on day 1 and 250 mg per day for days 2 to 5, or, oral levofloxacin, 500 mg q24h for 7 days.
  
  
  RESULTS
  Both treatments were well-tolerated, with the majority of adverse events being GI in nature. Favorable clinical outcomes in clinically evaluable patients were demonstrated in 89% of patients receiving azithromycin and in 92% of patients receiving levofloxacin by day 4 of therapy. At day 24, the posttherapy visit, favorable responses were approximately 82% and 86%, respectively, for patients in the two treatment groups. The bacterial eradication rates of respiratory pathogens were 96% for azithromycin and 85% for levofloxacin.
  
  
  CONCLUSIONS
  Despite increasing concerns over macrolide resistance and a higher incidence of Gram-negative pathogens, a standard 5-day course of oral azithromycin was clinically and bacteriologically equivalent to a 7-day course of oral levofloxacin in the treatment of patients with ABECB.
authors.affiliation: Clinical Pharmacology Research Center and Department of Adult and Pediatric Medicine, Bassett Healthcare, Cooperstown, NY 13326, USA. guy.amsden@bassett.org
authors.forename: Guy W
authors.initials: GW
authors.lastname: Amsden
authors.forename: Ian M
authors.initials: IM
authors.lastname: Baird
authors.forename: Stuart
authors.initials: S
authors.lastname: Simon
authors.forename: Glenda
authors.initials: G
authors.lastname: Treadway
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D029481:Bronchitis, Chronic / Q000382:microbiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D064704:Levofloxacin; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015242:Ofloxacin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D064704:Levofloxacin; D017963:Azithromycin; D015242:Ofloxacin