CEFACLOR VERSUS AMOXICILLIN-CLAVULANIC ACID FOR TREATMENT OF CHRONIC-BRONCHITIS ACUTE EXACERBATIONS

Cefaclor and amoxicillin-clavulanic acid (ACA) are used for several years in the treatement of acute exacerbation of chronic bronchitis. The aim of this study was to reassess the clinical efficacy of these 2 compounds in this indication. The study was designed as a multicentre (7 centres), open and randomized clinical trial. 89 patients were included, 48 patients treated with cefaclor (250 mg tid for 10 to 15 days) and 41 patients treated with amoxicillin-clavulanic acid (500 mg tid for 10 to 15 days). There were no statistically significant difference within groups with regard to the mean age, sex ratio, mean peak flow volume, the associated treatments (corticosteroids, betaeta-mimetics and theophyllin) and also to the degree of severity of exacerbation. For each patient a degree of severity defined as severe, moderate or minor was done. This classification was based on infectious criterion (pus in sputum and volume of sputum) and on respiratory criterion (level of dyspnea). At the end of the treatment there were no statistically significant difference between both regimen : 28/35 with ACA and 31/43 with cefaclor patients were cured or significantly improved. At the follow up visit the cure was confirmed for 19 /28 patients treated with AAC and 27/31 with cefaclor. The authors conclude at the same efficacy of the two drugs and the good tolerance especially for cefaclor. They discuss about the lowest efficacy as compared with others studies.