Effect of Loracarbef and Amoxicillin on the Oropharyngeal and Intestinal Microflora of Patients with Bronchitis

Abstract

The effect on the oropharyngeal and intestinal microflora and the efficacy and tolerance of loracarbef (200 mg b.i.d. for 7 days) versus amoxicillin (500 mg t.i.d. for 7 days) were compared in 80 patients with bronchitis. The oropharyngeal samples of 18% of patients in the amoxicillin group and 5% of patients in the loracarbef group revealed a new Gram-negative species around days 8–10. The presence of other aerobic bacteria than found at baseline in the faeces occurred in 38% of patients treated with amoxicillin compared with 31% in the loracarbef group on days 8–10. After treatment, no loracarbef-or amoxicillin-resistant aerobic Gram-negative bacteria were found in faecal samples in the loracarbef group, while amoxicillin-or loracarbef-resistant (E. coli) strains appeared in 35% of patients receiving amoxicillin (p < 0.001). Treatment success occurred by days 8–10 in all 40 patients receiving loracarbef, compared with 90% in the amoxicillin group, on days 21–28, in 93% and 90% respectively. The results of this study indicate that the use of loracarbef leads to minor changes in the normal oropharyngeal and intestinal microflora compared with amoxicillin, while almost no resistant Gram-negative bacteria emerge after treatment with loracarbef.