Journal of Antimicrobial Chemotherapy (1999) 44, 501-513
© 1999 The British Society for Antimicrobial Chemotherapy
Five day moxifloxacin therapy compared with 7 day clarithromycin therapy for the treatment of acute exacerbations of chronic bronchitis
a Royal Brompton Hospital and Imperial College of Science, Technology and Medicine, National Heart and Lung Institute, London SW3 6LR b Bayer plc, Pharmaceutical Division, Newbury RG14 1JA c Pendlebury Health Centre, Manchester M27 2HP, UK d Fachkrankenhaus für Lungenheilkunde und Thoraxchirurgie, Pneumologische Klinik, 13125 Berlin, Germany e Section of Infectious Diseases, University Hospital, 26500 Rion-Patras, Greece f Pneumology Unit, Rangueil Hospital, 31054 Toulouse, France g Department of Lung Diseases, Onze Lieve Vrouwe Gasthuis, 1091 HA Amsterdam, The Netherlands h Pulmonology Department, Hospital Clinic, 08036 Barcelona, Spain i Bayer Pharma, 92807 Puteaux Cedex, France
In this multinational, randomized, double-blind study, the efficacy and safety of a 5 day course of moxifloxacin 400 mg orally od was compared with that of a 7 day course of clarithromycin 500 mg orally bd in 750 patients with acute exacerbations of chronic bronchitis, characterized by at least two of the symptoms: sputum purulence, increased sputum volume or increased dyspnoea. Seven days after the end of therapy, clinical cure was achieved for 89% (287 of 322) of efficacy-evaluable patients in the moxifloxacin group and 88% (289 of 327) of patients in the clarithromycin group (95% CI, –3.9%, 5.8%). At follow-up (21–28 days post-treatment), the continued clinical cure rates were 89% (256 of 287) for moxifloxacin and 89% (257 of 289) for clarithromycin. A total of 342 pathogenic bacteria were isolated from the sputum of 287 patients. The most common pathogens were Haemophilus influenzae (37%), Streptococcus pneumoniae (31%) and Moraxella catarrhalis (18%). Seven days post-treatment, a successful bacteriological response was obtained for 77% (89 of 115) of patients in the moxifloxacin group and 62% (71 of 114) of patients in the clarithromycin group, indicating superiority of moxifloxacin (95% CI, 3.6%, 26.9%). Both treatments were well tolerated with few adverse events. This study demonstrated that for the treatment of acute exacerbations of chronic bronchitis a 5 day course of moxifloxacin 400 mg od was clinically equivalent and bacteriologically superior to a 7 day course of clarithromycin 500 mg bd.
* Correspondence address. Host Defence Unit, National Heart and Lung Institute, London SW3 6LR, UK. Tel: +44-171-351-8337; Fax: +44-171-351-8338; E-mail: r.wilson2{at}ic.ac.uk
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