EFFICACY AND TOLERANCE OF ERYTHROMYCIN ACISTRATE IN THE TREATMENT OF ACUTE EXACERBATIONS OF CHRONIC-BRONCHITIS IN THE ELDERLY

This randomized, investigator-blind, parallel-group trial compared ery thromycin acistrate (EA) and erythromycin base (EB) in the treatment o f elderly patients with acute exacerbations of chronic bronchitis. In total, 57 hospitalized patients were included, of whom 28 received EA 400 mg three times daily, and 29 EB 500 mg three times daily for 10-21 days. The mean age of the patients was 70 and 68 years in the EA and EB groups, respectively. The patients underwent medical examination be fore the onset of the study, at the 7th day during the treatment and 3 -5 days after termination of the treatment. The efficacy assessment wa s based on clinical signs and symptoms of infection as well as on bact eriological culture from sputum samples. 55% of the patients in the EA group and 61% in the EB group were totally cured, 23 and 29%, respect ively, had only mild symptoms at the end of the therapy and 14 versus 11% of the patients did not respond at all. The predominant pathogens isolated from sputum were Haemophilus influenzae, Branhamella catarrha lis and Streptococcus pneumoniae. 60% of the patients in the EA group and 46% in the EB group from whom a sample was taken had normal flora in the posttreatment culture. In the EA group, 8 patients and in the E B group 7 patients complained of gastrointestinal side effects and 4 a nd 1, respectively, discontinued the treatment prematurely. Slight, re versible elevations of one or more liver parenchymal enzyme activities during and after treatment were seen at the same frequency in both tr eatment groups. The results show that EA is as effective and well tole rated as EB in the treatment of exacerbations of chronic bronchitis in elderly patients.