Acute exacerbation of chronic bronchitis - Cefuroxime IM, followed by cefuroxime axetil versus ceftriaxone IM

A total of 110 adult community patients with acute exacerbation of chronic bronchitis randomly received either a 4-day course of cefuroxime injection (58 patients, 750 mg IM, bid) plus an 8-day course of cefuroxime axetil per os (250 mg, bid) or a 12-day course of ceftriaxone injection 1 000 mg IM, od (52 patients). Clinical success was defined by return to previous state at the end of treatment. The success rate reached 64 % in the cefuroxime group and 63 % in the ceftriaxone group. At the end of treatment (D12), therapeutic strategies were statistically equivalent on secondary criteria based on eradication of infection symptoms, such as fever and purulence of the sputum. Respective clinical success rates for simultaneous eradication of these symptoms were 52 (90 %) in the cefuroxime group, and 44 (85 %) in the ceftriaxone group. One month (D30), after the beginning of acute exacerbation, the evolution was also favorable in the cefuroxime group (93 %), and in the ceftriaxone group (96 % - statistically equivalent). Drug related adverse events were reported in respectively 5 % and 10 % of the cefuroxime and ceftriaxone treated patient. The patients' quality of life improved with both antibiotherapy (without any statistical difference). The present study showed that a sequential therapy of a 4 day course of cefuroxime IM followed by an 8 day course of cefuroxime axetil per os, is as effective and safe as a 12 day treatment with ceftriaxone IM in adults with an acute exacerbation of chronic bronchitis.