CLINICAL
OUTCOMES OF AMBULATORY ACUTE EXACERBATIONS OF CHRONIC BRONCHITIS WITH OLDER
VERSUS NEWER ANTIMICROBIALS.
Madaras-Kelly
KJ, et al. Ann Pharmacother 2002 Jun;36(6):975-80.
OBJECTIVE:
To determine whether the cure rate was similar between traditional and newer
antibiotics in the treatment of acute exacerbations of chronic bronchitis
(AECB), to determine whether antibiotic selection during the first AECB of the
season influences the frequency of subsequent AECB, and to identify variables
associated with poor short- and long-term treatment outcome.
METHODS:
A retrospective analysis of subjects seen for management of their first
seasonal AECB was conducted. Subjects were stratified into traditional
therapies (n = 95) or newer therapies (n = 101) by antibiotic prescription.
RESULTS:
There was no difference in initial cure rates between older versus newer
antibiotics (93% vs. 95%; p = 0.48). There was no difference in the number of
subjects that remained AECB-free for 6 months after initial treatment with
older versus newer antibiotic regimens (34% vs. 28%; p = 0.37). Oxygen initiation
or increased dose (OR 10.9; 95% CI 1.4 to 84.2; p = 0.02) was the only variable
independently associated with lack of AECB resolution. Nonsmoking status
trended toward an association with remaining AECB-free at 180 days (OR 0.39;
95% CI 0.15 to 1.01; p = 0.053).
CONCLUSIONS:
The use of older versus newer antibiotics did not independently predict
short-term outcome or future AECB.