COMPARATIVE-STUDY OF EFFICIENCY AND TOLER ANCE TO CLARITHROMYCIN AND CEFPODOXIME IN THE TREATMENT OF ACUTE BACTERIAL EXACERBATION OF CHRONIC-BRONCHITIS

A multicenter, open, randomized and comparative study in acute bacteri al exacerbration of chronic bronchitis was carried out in 12 French lo cations by 80 GPs supervised by a local co-ordinator, specialist in in fectious diseases and/or pneumology. 332 patients were enrolled in thi s study, 179 treated With clarithromycin 500 mg b.i.d. and 149 were tr eated with cefpodoxin proxetil, 200 mg b.i.d. Assessment of clinical e fficacy was made on intention-to-treat basis (171 patients with clarit hromycin and 149 with cefpodoxin proxetil). The main item assessed was the outcome, whether successful or not, according to sputum appearanc e. Successful clinical outcome was comparable for both groups, with 81 % for clarithromycin and 77% for cefpodoxin proxetil. Some patients ne eded a supplementary antibiotic treatment at day 12 or day 15, because the GP did not find the treatment efficient enough according to subje ctive criteria: 7.9% of the patients in the clarithromycin group, and 15% in the cefpodoxin proxetil group (a statistically significant diff erence). Most adverse effects were of mild or moderate severity (95% w ith clarithromycin and 98% with cefpodoxin proxetil). The difference b etween the two treatments was essentially the bitter taste left in the mouth (p=0.08) for 8 patients treated with clarithromycin. The result s of this study indicate that clarithromycin, with 500 mg administered twice daily, is as effective as cefpodoxin proxetil with 200 mg twice daily, in the treatment of acute bacterial exacerbation of chronic br onchitis.