Short-course fluoroquinolones in acute exacerbations of chronic bronchitis

Abstract

It is estimated that 50–70% of acute exacerbations of chronic bronchitis (AECB) are caused by bacterial infections. Appropriate selection of antimicrobials may lead to better outcomes and reduced healthcare costs. Respiratory fluoroquinolones (moxifloxacin, levofloxacin and gemifloxacin) have a broad spectrum of activity against most AECB-causing pathogens and are used as first-line treatment in patients with comorbidity, severe airway obstruction or recurrent exacerbations. We review studies, identified through a MEDLINE search, that compared clinical efficacy and speed of recovery for short-course (≤5 days) fluoroquinolone therapy with commonly prescribed standard therapy (≥7 days). Among 177 studies reporting the use of fluoroquinolones for AECB treatment, 23 used a short-course regimen, shown to be at least as effective as standard therapy of 7 or more days duration. Furthermore, evidence suggests that short-course therapy offers faster resolution of symptoms, faster rate of recovery, fewer relapses, fewer and shorter hospitalizations, and longer time between recurrences.

Keywords::

• acute exacerbations of chronic bronchitis
• AECB
• antibiotic therapy
• fluoroquinolones
• short-course therapy
• speed of recovery

Acknowledgements

The authors would like to acknowledge the editorial assistance of Ching-Ling Chen in the preparation of this manuscript.

Financial & competing interests disclosure

Mark H Gotfried has served on Advisory Boards for GlaxoSmithKline and Schering-Plough Co., and has received research support from Ortho-McNeil, Pfizer and GlaxoSmithKline. The authors accept full responsibility for the contents of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial assistance was utilized in the production of this manuscript. Support for this assistance was provided by Schering-Plough Co.