A randomized study was done to compare the efficacy of clarithromycin
250 mg or 500 mg b.i.d., vs. cefaclor 250 mg or 500 mg t.i.d. for 7-14
d in 197 evaluable patients with lower respiratory tract infection. N
inety-five patients received clarithromycin, 88 with acute bronchitis
or exacerbation of chronic bronchitis, and 7 with pneumonia. One hundr
ed and two patients received cefaclor, 86 with bronchitis and 16 with
pneumonia. Ten patients (10.5%) in the clarithromycin group did not co
mplete the trial, 5 (5.3%) because of adverse event, and 3 (3.2%) beca
use of clinical failure. Similarly, 11 patients (10.8%) did not comple
te cefaclor, 2 (2%) because of adverse event, and 7 (6.9%) because of
clinical failure. Clinical cure or improvement was observed in 90 (94.
7%) of patients on clarithromycin vs. 99 (90.2%) on cefaclor, p = 0.66
. Bacteriologic cure was seen in 26/36 patients (72.2%) on clarithromy
cin vs. 28/40 patients (70%) on cefaclor, p = 0.28. Clarithromycin is
just as effective as cefaclor for lower respiratory tract infections a
nd is well tolerated.