Efficacy and Tolerability of Clarithromycin versus Azithromycin in the Short-Course Treatment of Acute Bronchitis

Summary

In general practice it is common to prescribe antibiotics for patients with acute bronchitis presumed to be of bacterial origin. This phase III double-blind randomised multicentre study compared the efficacy and safety of clarithromycin 250mg twice daily administered for 5 days, and azithromycin 500mg once daily on day 1 followed by 250mg once daily on days 2 to 5, in the treatment of 214 adult patients with acute bronchitis. Clinical evaluations were performed pretreatment, on day 6 or 7, and at a follow-up visit between 20 to 30 days after the start of treatment.

Of the 214 patients enrolled in the study, 109 were in the clarithromycin group and 105 in the azithromycin group. The groups were matched for age, sex, smoking history and severity of actual disease.

Both regimens were well tolerated and effective. No significant differences were observed between the clarithromycin and azithromycin groups in post-treatment clinical cure (65%, 70 of 108; 53%, 55 of 103, respectively), in clinical success (96%, 104 of 108; 92%, 95 of 103, respectively), in relapse rates (1%, 1 of 101; 2%, 2 of 95) or in the numbers of patients reporting drug- related adverse events (12%, 13 of 109; 16%, 17 of 105, respectively).

Clarithromycin, administered for 5 days, was at least as effective and as safe as a 5-day azithromycin regimen in the treatment of acute bronchitis.