Clinical effectiveness and safety of gemifloxacin versus cefpodoxime in acute exacerbation of chronic bronchitis: A randomized, controlled trial

Chatterjee, Suparna; Biswas, Tuhin Kanti; Dutta, Arup; Sengupta, Gairik; Mitra, Anupam; Kundu, Soumi

doi:10.4103/0253-7613.75667

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Thirty-four RCTs included 45 descriptive instruments [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ]. All but three trials were deemed to be at high risk of methodological bias.…”

Section: Resultsmentioning

confidence: 99%

Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study

et al. 2021

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A recently published ERS core outcome set recommends that all trials of COPD exacerbation management should assess the treatment success (or “cure” of the exacerbation), defined as a dichotomous measure of the overall outcome of an exacerbation. This methodological systematic review describes and compares the instruments that were used to assess treatment success or failure in 54 such RCTs, published between 2006–2020. Twenty-three RCTs used composite measures consisting of several undesirable outcomes of an exacerbation, together defining an overall unfavourable outcome, to define treatment failure. Thirty-four RCTs used descriptive instruments that used qualitative or semi-quantitative descriptions to define cure, marked improvement, improvement of the exacerbation, or treatment failure. Treatment success and failure rates among patients receiving guidelines-directed treatments at different settings and timepoints are described and could be used to inform power calculations in future trials. Descriptive instruments appeared more sensitive to treatment effects compared to composite instruments. Further methodological studies are needed to optimise the evaluation of treatment success/failure. In the meantime, based on the findings of this systematic review, the ERS core outcome set recommends that cure should be defined as sufficient improvement of the signs and symptoms of the exacerbation such that no additional systemic treatments are required.

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Section: Resultsmentioning

confidence: 99%

Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study

et al. 2021

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“…В более позднем исследовании сравнивали эффективность гемифлоксацина с таковой цефподоксима (как эталонного препарата) у пациентов с обострениями ХБ II типа (по Anthonisen) [25]. Показатели клинической эффективности после 7-дневного курса лечения составили 84,6% и 83,3% в группах терапии гемифлоксацином и цефподоксимом соответственно.…”

Section: обострение хронического бронхита и хроническая обструктивная...unclassified

Oral third-generation cephalosporin cefpodoxime in the therapy of respiratory infections

Stetsiouk,

Andreeva,

Shevchik

2023

CMAC

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Oral 3rd generation cephalosporin cefpodoxime proxetil has been available in the antibiotic armamentarium for more than 30 years, however, unlike other oral cephalosporins (e.g. cefixime), it has not been given due recognition in clinical practice in Russia due to its low availability on the domestic pharmaceutical market. At the same time, the high activity of cefpodoxime against respiratory pathogens (S. pneumoniae, H. influenzae and S. pyogenes), pharmacological characteristics, results of clinical trials of its safety and efficacy, allow us to discuss the inclusion of this antimicrobial into Russian clinical guidelines for the treatment of community-acquired respiratory infections, primarily in outpatients, as well as for stepdown therapy of these infections in the hospital. In addition, cefpodoxime is a reliable option to replace parenteral therapy, in particular with ceftriaxone, which is unreasonably often prescribed in outpatient practice in Russia, without the threat of loss of the treatment efficacy.

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Antibiotics for exacerbations of chronic obstructive pulmonary disease

Vollenweider

Jarrett

Steurer-Stey

et al. 2012

Cochrane Database of Systematic Reviews

241

122

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BACKGROUND: Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are treated with antibiotics. However, the value of antibiotics remains uncertain as systematic reviews and clinical trials have shown conflicting results. OBJECTIVES: To assess the effects of antibiotics in the management of acute COPD exacerbations on treatment failure as observed between seven days and one month after treatment initiation (primary outcome) and on other patient-important outcomes (mortality, adverse events, length of hospital stay). SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and other electronically available databases up to September 2012. SELECTION CRITERIA: Randomised controlled trials (RCTs) in people with acute COPD exacerbations comparing antibiotic therapy and placebo with a follow-up of at least seven days. DATA COLLECTION AND ANALYSIS: Two review authors independently screened references and extracted data from trial reports. We kept the three groups of outpatients, inpatients and patients admitted to the intensive care unit (ICU) separate for benefit outcomes and mortality because we considered them to be clinically too different to be summarised in one group. We considered outpatients to have a mild to moderate exacerbation, inpatients to have a severe exacerbation and ICU patients to have a very severe exacerbation. Where outcomes or study details were not reported we requested missing data from the authors of the primary studies. We calculated pooled risk ratios (RR) for treatment failure, Peto odds ratios (OR) for rare events (mortality and adverse events) and weighted mean differences (MD) for continuous outcomes using fixed-effect models. We used GRADE to assess the quality of the evidence. MAIN RESULTS: Sixteen trials with 2068 participants were included. In outpatients (mild to moderate exacerbations), there was evidence of low quality that antibiotics did statistically significantly reduce the risk for treatment failure between seven days and one month after treatment initiation (RR 0.75; 95% CI 0.60 to 0.94; I(2) = 35%) but they did not significantly reduce the risk when the meta-analysis was restricted to currently available drugs (RR 0.80; 95% CI 0.63 to 1.01; I(2) = 33%). Evidence of high quality showed that antibiotics statistically significantly reduced the risk of treatment failure in inpatients with severe exacerbations (ICU not included) (RR 0.77; 95% CI 0.65 to 0.91; I(2) = 47%) regardless of whether restricted to current drugs. The only trial with 93 patients admitted to the ICU showed a large and statistically significant effect on treatment failure (RR 0.19; 95% CI 0.08 to 0.45; high-quality evidence).Evidence of low-quality from four trials in inpatients showed no effect of antibiotics on mortality (Peto OR 1.02; 95% CI 0.37 to 2.79). High-quality evidence from one trial showed a statistically significant effect on mortality in ICU patients (Peto OR 0.21; 95% CI 0.06 to 0.72). Length of hospital stay (in da...

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Clinical effectiveness and safety of gemifloxacin versus cefpodoxime in acute exacerbation of chronic bronchitis: A randomized, controlled trial

Cited by 4 publications

References 11 publications

Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study

Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study

Oral third-generation cephalosporin cefpodoxime in the therapy of respiratory infections

Antibiotics for exacerbations of chronic obstructive pulmonary disease

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