New oral quinolone compounds in chronic bronchitis
Abstract
Clinical, microbiological and pharmacokinetic results are presented from studies in 186 patients treated with the new quinolone antimicrobial agents enoxacin, pefloxacin, ciprofloxacin or ofloxacin. Almost all had been admitted to hospital for acute purulent exacerbations of chronic bronchitis, associated mainly with Haemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis or Pseudomonas aeruginosa. The H. influenzae and B. catarrhalis strains were generally very sensitive to the quinolones and sputum concentrations of 1.3 to 4.5 mg/l exceeded the MICs (geometric mean values 0.07 to 0.44 mg/l) by a factor of more than 10. In contrast, P. aeruginosa was slightly less sensitive (geometric mean MICs 0.4 to 4.4 mg/l) and S. pneumoniae much less so (with geometric mean MICs between 0.84 and 6.7 mg/l) and a number of treatment failures were noted with these organisms. Various unwanted drug effects (mostly upper gastro-intestinal) were seen, particularly with enoxacin. The best clinical results were observed with ofloxacin, even with once daily dosage, but the results with the other quinolones could only be described as moderate.
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