Journal of Antimicrobial Chemotherapy (1999) 44, 515-523
© 1999 The British Society for Antimicrobial Chemotherapy
Randomized, double-blind study of short-course (5 day) grepafloxacin versus 10 day clarithromycin in patients with acute bacterial exacerbations of chronic bronchitis
a Baillieston Health Centre, 20 Muirside Rd, Glasgow G69AD, UK b Hôpital Notre Dame de Bon Secours, Service Médecine Interne-Pneumologie 1, Place Phillippe de Vigneulles, 57000 Metz, France c Kliniken des Main-Taunus-Kreises, Lindenstrasse 10, 65719 Hofheim, Germany d Sunnybrook Health Science Centre, A456-2075 Bayview Ave, Toronto, Canada, M4N 3M5 e Katerda i Klinika Pneumonologii SLAM, ul. Medykow 4, 40-752 Katowice, Poland f Ke stacirne 608, 149 00 Praha 4, Czech Republic g Glaxo Wellcome R&D Greenford Rd, Greenford, Middlesex UB6 0HE, UK
The efficacy and safety of grepafloxacin were compared with clarithromycin in a randomized, double-blind, multicentre clinical trial of 805 patients with acute bacterial exacerbations of chronic bronchitis (ABECB). Patients were randomized to receive grepafloxacin 400 mg od for either 5 (n = 273) or 10 days (n = 268) or clarithromycin 250 mg bd for 10 days (n = 261). Patients were assessed pre-treatment, 3–5 days during treatment, 1–3 days post-treatment and at follow-up (21–28 days post-treatment). The clinical success rates for the evaluable patients were 91% in the 5 day grepafloxacin group, 95% in the 10 day grepafloxacin group and 86% in the clarithromycin group. At follow-up, respective rates were 72%, 81% and 73%. A total of 513 pathogens were isolated from the pre-treatment sputum specimens of 400 (49%) patients. The primary pathogens were Haemophilus influenzae (36% of isolates), Haemophilus parainfluenzae(27%), Moraxella catarrhalis (12%), Streptococcus pneumoniae (11%) and Staphylococcus aureus (3%). Pathogens were eradicated or presumed eradicated at post-treatment in 85%, 91% and 58% of evaluable patients treated with grepafloxacin for 5 days, grepafloxacin 10 days and clarithromycin 10 days, respectively. The eradication rates in both grepafloxacin groups were significantly greater than the clarithromycin group (P< 0.001). All treatments were well tolerated and incidence of drug-related adverse events in each group was comparable. This study demonstrates that both a 5 and a 10 day regimen of grepafloxacin 400 mg od are as clinically and bacteriologically effective as in the treatment of ABECB clarithromycin 250 mg bd for 10 days.
* Corresponding author. Tel: +44-181-966-3962; Fax: +44-181-966-3988; E-mail: CLPM0454{at}glaxowellcome.co.uk
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