Ofloxacin compared with amoxycillin in treating infective exacerbations in bronchiectasis

Lam, Wah‐Kit; Chau, Pui Hing; So, S. Y.; Leung, Y. K.; Chan, Johnny C. Y.; Ip, Msm; Sham, Minakshi

doi:10.1016/s0954-6111(89)80200-8

Cited by 25 publications

(24 citation statements)

References 6 publications

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Section: Clinical Assessmentmentioning

confidence: 99%

“…Patients were asked to score severity of cough as 0, 1, 2, 3 or 4 corresponding to no, very mild, mild, moderate and severe cough respectively, using a visual analogue chart [3]. Dyspnoea score was assessed similarly [3]. Patients were withdrawn if there was failure to improve clinically (defined as no change in the clinical or sputum score compared with day 1) or deterioration (defined as deterioration in original respiratory symptom or sputum scores, or the emergence of new respiratory symptoms).…”

Section: Clinical Assessmentmentioning

confidence: 99%

“…Whilst the pathogenesis of bronchiectasis clearly includes infective and inflammatory elements [1] and it has recently been shown that inhaled fluticasone therapy is effective in reducing airway inflammation [2], antibiotic therapy remains the mainstay of treatment in exacerbations. Pseudomonas aeruginosa constituted 25±50% of sputum bacterial isolates in Hong Kong [3], rendering most b-lactam antibiotics theoretically ineffective. Standard agents directed against Pseudomonas, such as ceftazidime, aminoglycosides and imipenem, however, require parenteral administration.…”

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confidence: 99%

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A comparative study on the efficacy of levofloxacin and ceftazidime in acute exacerbation of bronchiectasis

Tsang¹,

Chan²,

Ho³

et al. 1999

Eur Respir J

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A prospective randomized study was performed in order to compare the efficacy of oral levofloxacin, a new S-isomer of ofloxacin, with intravenous ceftazidime in the empirical treatment of acute exacerbations of bronchiectasis.Consecutive patients with acute exacerbation of bronchiectasis were recruited at a tertiary referral centre and were randomized to receive 10 days' treatment with either oral levofloxacin (300 mg b.i.d.) or ceftazidime (1 g i.v. t.i.d.). Body temperature, cough score, dyspnoea score, sputum purulence and volume and white blood cell and neutrophil count were assessed on day 1 and day 10.Thirty-five patients (mean age 61 yrs, 15 males) completed the study; 17 of these were in the levofloxacin group. There was no significant difference in the distribution of sputum pathogens or clinical parameters between the two groups at entry to and completion of the study. Both groups of patients showed significant improvement in 24-h sputum volume, sputum purulence score, cough score and dyspnoea score (p<0.001) but there was no significant difference between these two groups at entry to or on completion of the study (p>0.05).The results of this study suggest that oral administration of levofloxacin is as effective as parenteral ceftazidime in the empirical treatment of exacerbations in bronchiectasis.

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Section: Clinical Assessmentmentioning

confidence: 99%

Section: Clinical Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

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A comparative study on the efficacy of levofloxacin and ceftazidime in acute exacerbation of bronchiectasis

Tsang¹,

Chan²,

Ho³

et al. 1999

Eur Respir J

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“…2 It is believed that antibiotics reduce the bacterial load and, therefore, lessen the damage. 13,14 In patients hospitalized with severe infection, PA should be considered a possible pathogen, and antibiotics coverage should, at least initially, include PA until information on culture and sensitivity is available. Strains of PA in this study were sensitive to ceftazidime and ciprofloxacin.…”

Section: Discussionmentioning

confidence: 99%

“…Strains of PA in this study were sensitive to ceftazidime and ciprofloxacin. In a study in Hong Kong, 14 ofloxacin, a fluoroquinolone, was shown to be more effective than amoxycillin in treating infective episodes in bronchiectasis, again probably because of the predominance of PA.…”

Section: Discussionmentioning

confidence: 99%

Pseudomonas Aeruginosa in Hospitalized Patients with Infective Exacerbations of Bronchiectasis: Clinical and Research Implications

et al. 1998

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A Al-Mobeireek, A-M Kambal, SR Al-Balla, H Al-Sawwaf, S Saleemi, Pseudomonas Aeruginosa in Hospitalized Patients with Infective Exacerbations of Bronchiectasis: Clinical and Research Implications. 1998; 18(5): 469-471 Bronchiectasis is becoming less of a problem in developed countries since the advent of antibiotics and the implementation of immunization programs.1,2 It is still, however, a significant cause of illness in developing countries. To our knowledge, there are no statistics on the prevalence of bronchiectasis in Saudi Arabia. Nonetheless, many chest physicians would agree that patients with this disease are seen frequently, both in the outpatient and the inpatient settings.Acute infective exacerbations related to bacterial pathogens are common and remain an important cause of morbidity and mortality in bronchiectasis. Even in the "stable" status between these exacerbations, it is believed that these organisms contribute to the perpetuation of the chronic inflammatory process and progressive lung damage. Identification and appropriate treatment of these pathogens is an essential part of the management.2 The objective of this study was to determine the range and sensitivity of bacterial pathogens that are isolated from the respiratory secretions of patients admitted with infective exacerbations of bronchiectasis. Findings are compared with other studies, and the significance of bacterial isolates, particularly Pseudomonas aeruginosa, is discussed. Patients and MethodsThe study was conducted prospectively at King Khalid University Hospital (KKUH) and Sahary Chest Hospital in Riyadh, during the years 1994-1995. Both health institutions function as general and tertiary referral hospitals, serving the Central Province (Najd), but also at times accepting patients from other parts of the Kingdom.All patients had bronchiectasis, defined by a history of chronic productive cough and an abnormal permanent dilatation of one or more bronchi on plain film or computed tomography. These patients were admitted to one of the above hospitals through the emergency department on the basis of features that were compatible with infective exacerbations. For the purpose of this study, an infective exacerbation was defined as an increase in sputum quantity, or a change in the character of the sputum from mucoid to purulent. Patients were questioned about cough, sputum (quantity, color), hemoptysis, dyspnea, fever, the chronicity of these symptoms, any recent change, any preceding flu-like illness suggesting an upper respiratory tract infection (URTI), and the use of antibiotics within one month before admission. None of the patients had clinical features of cystic fibrosis (CF), and all patients under 20 years of age underwent sweat chloride tests.Sputum samples were collected in sterile bottles and sent to the Microbiology Laboratory at KKUH and processed within one to two hours, or were kept at 4°C until processing. Gram staining was done by selecting a purulent portion of the specimen and spreading it on a microscopic sli...

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Prolonged antibiotics for purulent bronchiectasis

Evans

Bara

Greenstone

2002

Cochrane Database of Systematic Reviews

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Ofloxacin compared with amoxycillin in treating infective exacerbations in bronchiectasis

Cited by 25 publications

References 6 publications

A comparative study on the efficacy of levofloxacin and ceftazidime in acute exacerbation of bronchiectasis

A comparative study on the efficacy of levofloxacin and ceftazidime in acute exacerbation of bronchiectasis

Pseudomonas Aeruginosa in Hospitalized Patients with Infective Exacerbations of Bronchiectasis: Clinical and Research Implications

Prolonged antibiotics for purulent bronchiectasis

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