OPEN RANDOMIZED STUDY COMPARING DOXYCYCLINE AND CO-AMOXICLAV IN THE TREATMENT OF ACUTE SUPPURATIVE TRACHEOBRONCHITIS IN ADULTS

Doxycycline and co-amoxiclav were compared in a randomized clinical tr ial involving adult patients with acute suppurative tracheobronchitis. Patients were treated for 5 to 10 days with either antibiotic followi ng three schemes: co-amoxiclav 500 mg three times daily, or doxycyclin e 200 mg on day 1 followed by 100 mg daily, or 200 mg daily. Assessmen t after 5 - 9 days was based only on clinical parameters. Patients wit h inadequate response to the initial treatment were crossed over to th e alternative antibiotic. Of the 210 patients enrolled, 206 were avail able for evaluation of efficacy. Both antibiotic regimens proved equal ly efficacious, with rates of clinical response (cure or improvement) of 89% and 91% for doxycycline and coamoxiclav, respectively. Patients who were crossed over to the alternative antibiotic had a significant ly lower cure rate after their second course of antibiotics (22% compa red with 70%). Adverse effects, most often of gastro-intestinal origin , were more common in the co-amoxiclav group than in the doxycycline-t reated group, but rarely caused cessation of treatment.