5 DAYS TREATMENT OF ACUTE PURULENT BRONCHITIS IN THE ELDERLY WITH CEFPODOXIME PROXETIL

This single-blind randomized multicenter study compared the clinical efficacy and safety of a 5 days treatment with cefpodoxime proxetil (CPD) 200 mg BID to a 10 days treatment with cefuroxime axetil (CXM) 250 mg BID. Thirty three general practitionners together with five pulmonologist or infectiologist coordinators enrolled 187 patients in this study, 92 in the CPD group and 95 in the CXM one. All the elderly patients suffered an acute purulent bronchitis with fever greater-than-or-equal-to 38-degrees-C, cough and purulent expectoration for less than two weeks. The mean ages of the patients were 73,8 (+/- 6,5) years in the CPD group and 73,2 (+/- 7,1) years in the CXM group. Associated chronic conditions were present respectively in 78,2 % of the CPD group patients and 68,4 % of those from the CXM group. By the end of the treatment the intent-to-treat analysis revealed an equivalent efficacy in both groups, with a satisfactory clinical response in 94,6 % of the CPD patients (87/92) and in 90,5 % (86/95) of the CXM group. During the follow-up visit, 3 to 4 weeks later, no recurrence or other infection was observable in respectively 97,7 % (85/87) and 94,2 % (81/86) of the CPD and CXM patients. Adverse events occurred among 6,5 % (6/92) of the CPD patients and 4,2 % (4/95) of the CXM group. These led four patients in the CPD group and two in the CXM group to stop their treatment. To conclude, in the elderly people with acute purulent bronchitis, a five days treatment with cefpodoxime proxetil (200 mg BID) was as effective as a ten days treatment with cefuroxime axetil (250 mg BID). Recurrences or new infections occurred respectively in 2,3 % and 5,8 % of the CPD and CXM group. The safety of the two antibiotics was comparable.