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Journal of Antimicrobial Chemotherapy (1995) 36, 173-183
© 1995 The British Society for Antimicrobial Chemotherapy

research-article

A comparison of 5 days of dirithromycin and 7 days of clarithromycin in acute bacterial exacerbation of chronic bronchitis

J. Hosiea, P. Quinnb, P. Smitsc and G. Sidesd,d*

aGreat Western Medical 1980 Great Western Road, Glasgow, UK bThe Health Centre Wine Street, Sligo, Ireland cLilly Research Centre Ltd Windlesham, UK dLilly Research Laboratories, Lilly Corporate Center Indianapolis, Indiana 46285, USA dLilly Research Laboratories, Lilly Corporate Center Indianapolis, Indiana 46285, USA

Received 4 February 1994; returned 31 October 1994; accepted 31 January 1995

*Corresponding author.

The safety and efficacy of dirithromycin and clarithromycin were compared in a single-blind, multicentre study of patients with acute bacterial exacerbation of chronic bronchitis (AECB). Patients received either dirithromycin, 500 mg once daily for 5 days, or clarithromycin, 250 mg twice daily for 7 days. A total of 212 patients entered the study, of whom 191 qualified for efficacy analysis. Favourable post-therapy clinical and bacteriological response rates for qualified patients(95 dirithromycin and 96 clarithromycin) were similar: 89.5% and 68.8% for dirithromycin vs 94.8% and71.9% for clarithromycin. At late post-therapy evaluation, favourable clinical and bacteriological response rates were achieved in 98.8% and 96.2% of dirithromycin patients and 95.3% and 93.3% of clarithromycin patients, respectively. These differences were neither statistically nor clinically significantly different. Both drugs had similar efficacy against Haemophilus inftuenzae and both were well tolerated. Dirithromycin, administered as a single daily dose for just 5 days resulted in complete compliance in all but four patients. In clarithromycin-treated patients, requiring a 7-day course of twice-daily treatment, compliance was less satisfactory, with 12 patients failing to comply, though the between-group difference was not statistically significant. It can be concluded that 5 days of dirithromycin, 500 mg once daily is as safe and ef fective as 7 days of clarithromycin, 250 mg, twice daily in the treatment of AECB.


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