Comparison of 5-day, short-course gatifloxacin therapy with 7-day gatifloxacin therapy and 10-day clarithromycin therapy for acute exacerbation of chronic bronchitis

Gotfried, Mark H.; DeAbate, C. Andrew; Fogarty, Charles; Mathew, Chavaramplakic P; Sokol, William N.

doi:10.1016/s0149-2918(01)80033-3

Cited by 48 publications

(13 citation statements)

References 22 publications

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“…Four trials did not specify how exacerbation was defined 20 – 22. All other trials included only patients satisfying at least two of the following criteria: increased cough and/or dyspnoea, increased sputum volume and increased purulence (ie, a type 1 or 2 exacerbation as defined by Anthonisen et al 8).…”

Section: Resultsmentioning

confidence: 99%

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

Moussaoui¹,

Roede

Speelman³

et al. 2008

Thorax

100

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Background: A study was undertaken to determine whether a short course of antibiotic treatment ((5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD). Methods: MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched to July 2006. Studies considered eligible were double-blind randomised clinical trials including adult patients >18 years of age with a clinical diagnosis of exacerbation of COPD or chronic bronchitis, no antimicrobial therapy at the time of diagnosis and random assignment to antibiotic treatment for (5 days versus .5 days. The primary outcome measure was clinical cure at early follow-up on an intention-to-treat basis.Results: 21 studies with a total of 10 698 patients were included. The average quality of the studies was high: the mean (SD) Jadad score was 3.9 (0.9). At early follow-up (,25 days), the summary odds ratio (OR) for clinical cure with short treatment versus conventional treatment was 0.99 (95% CI 0.90 to 1.08). At late follow-up the summary OR was 1.0 (95% CI 0.91 to 1.10) and the summary OR for bacteriological cure was 1.05 (95% CI 0.87 to 1.26). Similar summary ORs were observed for early cure in trials with the same antibiotic in both arms and in studies grouped by the antibiotic class used in the short-course arm. Conclusions: A short course of antibiotic treatment is as effective as the traditional longer treatment in patients with mild to moderate exacerbations of chronic bronchitis and COPD.

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Section: Resultsmentioning

confidence: 99%

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

Moussaoui¹,

Roede

Speelman³

et al. 2008

Thorax

100

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“…A number of studies using different classes of antibiotics, including fluoroquinolones [24][25][26][27][28][29][30][31][32][33][34][35], have been conducted to compare the efficacy of different time courses of antibiotic therapy in the treatment of AECB. Results from these studies all demonstrated that comparable clinical resolution can be attained with a shorter course (≤5 days) of antimicrobial treatment compared with commonly prescribed standard therapy (≥7 days).…”

Section: Short-course Fluoroquinolone Therapymentioning

confidence: 99%

Short-course fluoroquinolones in acute exacerbations of chronic bronchitis

Gotfried¹,

Grossman

2010

Expert Review of Respiratory Medicine

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It is estimated that 50-70% of acute exacerbations of chronic bronchitis (AECB) are caused by bacterial infections. Appropriate selection of antimicrobials may lead to better outcomes and reduced healthcare costs. Respiratory fluoroquinolones (moxifloxacin, levofloxacin and gemifloxacin) have a broad spectrum of activity against most AECB-causing pathogens and are used as first-line treatment in patients with comorbidity, severe airway obstruction or recurrent exacerbations. We review studies, identified through a MEDLINE search, that compared clinical efficacy and speed of recovery for short-course (≤ 5 days) fluoroquinolone therapy with commonly prescribed standard therapy (≥ 7 days). Among 177 studies reporting the use of fluoroquinolones for AECB treatment, 23 used a short-course regimen, shown to be at least as effective as standard therapy of 7 or more days duration. Furthermore, evidence suggests that short-course therapy offers faster resolution of symptoms, faster rate of recovery, fewer relapses, fewer and shorter hospitalizations, and longer time between recurrences.

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“…In patients with acute exacerbations of chronic bronchitis, a number of randomized, controlled, comparative trials of highly active antimicrobial agents have shown that 3-to 5-day regimens of drugs such as ceftibuten, cefdinir, dirithromycin, telithromycin, and the fluoroquinolones (e.g., levofloxacin, gemifloxacin, moxifloxacin, and gatifloxacin) are as effective as 7-or 10-day regimens of amoxicillin-clavulanic acid, cefprozil, cefuroxime axetil, clarithromycin, and levofloxacin [18][19][20][21][22][23][24][25][26].…”

Section: Contemporary Clinical Experience With Short-course Therapy Fmentioning

confidence: 99%

Clinical Efficacy of Newer Agents in Short-Duration Therapy for Community-Acquired Pneumonia

File

2004

Clinical Infectious Diseases

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Streptococcus pneumoniae, the most important respiratory tract pathogen implicated in community-acquired pneumonia (CAP), is becoming increasingly resistant in vitro to the beta -lactams and macrolides, and fluoroquinolone resistance has been detected. A growing body of evidence suggests that prolonged antimicrobial use may contribute directly and indirectly to increased antimicrobial resistance among common respiratory pathogens. Long-term exposure to antimicrobial agents, especially less-potent agents, directly increases selection pressure for resistance. Indirectly, poor patient compliance, multiple daily dosing, and the increased risk of adverse events further complicate the resistance issue and diminish the efficacy of long-term antimicrobial use. Controlled clinical trials addressing the appropriate duration of therapy for CAP are lacking. However, available data suggest that with appropriate antibiotic selection, based on appropriate spectrum, potency, and pharmacokinetic/pharmacodynamic profile, lower respiratory tract infections in outpatients can be successfully treated in <7 days rather than the 7-14 days currently recommended.

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Comparison of 5-day, short-course gatifloxacin therapy with 7-day gatifloxacin therapy and 10-day clarithromycin therapy for acute exacerbation of chronic bronchitis

Cited by 48 publications

References 22 publications

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

Short-course fluoroquinolones in acute exacerbations of chronic bronchitis

Clinical Efficacy of Newer Agents in Short-Duration Therapy for Community-Acquired Pneumonia

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