ADDITIVE EFFECT OF CONTINUOUS LOW-DOSE OFLOXACIN ON ERYTHROMYCIN THERAPY FOR SINOBRONCHIAL SYNDROME

It has been established that long-term low-dose erythromycin therapy ( EM therapy) is very effective for sinobronchial syndrome, a common con dition in Japan characterized by chronic upper and lower airway inflam mation. The effect does not result from its bacteriocidal activity and the detailed mechanisms are not known. It takes 3-6 months for EM the rapy to improve the symptoms. This study was designed to evaluate the additive effect of continuous low dosage or intermittent usual dosage of ofloxacin (OFLX) on EM therapy in patients with sinobronchial syndr ome. Patients with sinobronchial syndrome were randomly allocated to r eceive one of the following four regimens. Patients in Group A receive d both low-dose OFLX and EM therapy daily for 6 months. Patients in Gr oup B received EM therapy and intermittent treatment of OFLX for 6 mon ths. Patients in Group C underwent EM therapy for 6 months. Patients i n Group D received neither OFLX nor EM therapy. All patients were give n carbocystein for more than 2 months before starting each treatment a nd during the study period. In patients receiving OFLX and/or EM thera py, these antimicrobial agents were well-tolerated during the treatmen t period. Amount of sputum in the morning was significantly less in Gr oup C than in Group D after 3-6 months, and decreased significantly in Group A as compared with Group B after 2 weeks, Group C after 2 weeks to 2 months, and Group D after 2 weeks to 6 months. Other symptoms su ch as number of expectorations, difficulty of expectoration and severi ty of cough also improved rapidly in Group A. These findings suggest t hat it is useful to add low-dose OFLX to EM therapy for sinobronchial syndrome, especially within 1-2 months from starting treatment, and it may be cost-effective as this combination therapy can shorten the tre atment period of EM therapy.