A well-controlled comparative clinical study of the combination regimen of ciprofloxacin plus erythromycin for the treatment of repeated acute exacerbations of chronic respiratory tract infections

Akira Watanabe, Masakichi Motomiya, Toshihiro Nukiwa, Yushi Nakai, Yoshihiro Honda, Kiyoshi Konno, Ken ichi Takeuchi, Jun Nakagawa, Hideo Arai, Shigeru Shimoda, Harukuni Sasaki, Masahiro Sakamoto, Tetsuko Ishikawa, Yoichi Fukuda, Toshio Nakamura, Shigeo Takizawa, Kenji Yanase, Mikae Nakamura, Kataro Oizumi, Yoichiro IchikawaNaoto Tokunaga, Rumi Shima, Shigeru Komatsu

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)

    Abstract

    Three oral prophylactic regimens, each 6 months in duration, with ciprofloxacin (CPFX) and/or erythromycin (EM): a single drug regimen with 1×200 mg/day each of ciprofloxacin (regimen A) or erythromycin alone (regimen B), and a combined regimen with 1×200 mg/day each of ciprofloxacin and erythromycin (regimen C) were compared as to efficacy in controlling repeated exacerbations of chronic respiratory tract infections. The 50 patients included in this study consisted of 19 with bronchiectasis, 15 with chronic bronchitis, eight with chronic pulmonary emphysema, six with diffuse pan-bronchiolitis, one each with pulmonary fibrosis and old pulmonary tuberculosis, : 15 on regimen A, 17 on regimen B and 18 on regimen C. By comparing the pre-study period with the intra-study period, it was found that the corrected mean incidence of exacerbations per case decreased from 1.73 to 0.71 with regimen A, from 2.35 to 1.71 with regimen B, and from 2.47 to 1.38 with regimen C. With regimens B and C there was a significant difference in the incidence of exacerbation between the prestudy period and the intra-study period, as shown by statistical analysis using the cumulative χ2-test, when the severity of infection was also taken into consideration. One case on regimen C was excluded from evaluation because no documents were available concerning the incidence of acute exacerbation during the six months prior to the study. During exacerbations, several species of potential pathogens were isolated from regimen B subjects. On the other hand, potential pathogens other than Pseudomonas aeruginosa were isolated only infrequently fromthose on regimens A and C. The development of resistant strains was not clinically important, because only 1 of 10 persistent isolates of P. aeruginosa acquired a discernible degree of resistance to ciprofloxacin during the study, as shown by the results of MIC determination (MIC: 0.05→3.13). Safety was evaluated in 58 patients, namely in the above 50 patients plus six patients in whom evaluation of clinical efficacy could not be made because no clinical data and bacteriological documents were available, and in two other patients for whom treatment was interrupted because of adverse reactions within three months after the start of the study. Abnormalities in laboratory findings related to adverse reactions, which were found in one patient on regimen A and in three patients on regimen C, returned to normal and/or disappeared immediately after cessation of the therapy. From the above results, we conclude that the long-term administration of new-quinolones and macrolides, especially of combined regimens using both, is useful in controlling acute exacerbations of chronic repiratory tract infections.

    Original languageEnglish
    Pages (from-to)1194-1201
    Number of pages8
    JournalChemotherapy
    Volume42
    Issue number10
    DOIs
    Publication statusPublished - 1994 Jan 1

    Keywords

    • ciprofloxacin
    • erythromycin

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Infectious Diseases
    • Pharmacology
    • Drug Discovery
    • Oncology

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