Source: Annual Congress 2002 - Acute exacerbations of COPD: aetiology and therapy
Disease area: Airway diseases, Respiratory infections

Abstract

Background: Acute exacerbations of COPD (ABECOPD) contribute considerably to the morbidity and the diminished quality of life experienced by COPD patients.
Objective: We aimed to compare the safety and efficacy of azithromycin to ciprofloxacin for the treatment of patients with ABECOPD.
Methods: A study involved 443 COPD patients (mean age 66 ±] 17 years) with clinical and bacteriologic evidence of a acute bacterial exacerbation. Patients were randomized to either oral ciprofloxacin 500 mg/12 h for 10 days (CIP, 223 patients) or azithromycin 500 mg/24 h for 3 days (AZ, 220 patients). All patients were treated on an outpatient basis. Lung function tests, sputum culture, routine blood tests and chest x-rays were performed before the beginning and 3 days after the end of therapy with antibiotics. No significant differences were found between the two groups with regards to demographic, clinical, physical and laboratory data.
Results: The rate of clinical resolution were 88% for 10-day ciprofloxacin and 90% for 3-day azithromycin. Haemophilus spp (54%), M. catarrhalis (23 %), S. aureus (10 %), P. aeruginosa (7 %), E. colli (3 %) and S. pneumoniae (3 %) were isolated before the treatment. Bacteriological eradication rates at the end of therapy were 91% for ciprofloxacin and 94% for the azithromycin group. Headache, diarrhea, abdominal pain and nausea were the most common drug-related events reported in each treatment group.
Conclusion: Azithromycin 500 mg once a day for 3 days was found to be clinically and microbiologically effective as 10 day ciprofloxacin 500 mg/12 h for the therapy of patients with ABECOPD.

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Citations should be made in the following way:
M. D. Filipovic, S. S. Cekic, O. B. Dimitrijevic (Nis, Yugoslavia). Efficacy of azithromycin vs. ciprofloxacin in the treatment of patients with acute bacterial exacerbations of chronic obstructive pulmonary disease (COPD). Eur Respir J 2002; 20: Suppl. 38, 3373

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