Pefloxacin in acute exacerbations of chronic bronchitis

• Published in: Journal of antimicrobial chemotherapy 1985-09, Vol.16 (3), p.379-388
• Main Authors: Maesen, F. P. V., Davies, B. I., Teengs, J. P.
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - blood; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacteria - drug effects; Biological and medical sciences; Branhamella catarrhalis; Bronchitis - complications; Bronchitis - drug therapy; Bronchitis - microbiology; Chronic Disease; Female; Haemophilus influenzae; Humans; Kinetics; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Norfloxacin - analogs & derivatives; Norfloxacin - blood; Norfloxacin - therapeutic use; Pefloxacin; Pharmacology. Drug treatments; Pseudomonas aeruginosa; Streptococcus pneumoniae
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/16.3.379

Forty-three patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated with 400 mg pefloxacin twice daily for ten days. The first 20 patients were given the first dose of the drug as a 60 min intravenous infusion. Serum and sputum concentrations of pefloxacin were measured microbiologically at intervals on the first treatment day and the sputum was cultured before, during, and after the course of pefloxacin. Two patients died from unrelated causes during the follow-up and one refused to continue treatment. All strains of Haemophilus influenzae and Branhamella catarrhalis were eradicated at end-of-treatment but eight strains of Streptococcus pneumoniae and three of Pseudomonas aeruginosa were cultured and the sputum remained purulent despite the pefloxacin. Peak serum concentrations averaged approximately 4·5 mg/1 after the infusion and 5 mg/1 on oral administration, the corresponding sputum concentrations being 3·8 and 4·6 mg/1, respectively. MICs for H. influenzae were 0·06 mg/1, or less. Mode MICs for the pre- and post-treatment strains of Str. pneumoniae were 4 and 16 mg/1, and the corresponding values for Ps. aeruginosa were 2 and 16 mg/1. The poor results in pseudomonas and pneumococcal infections could largely be explained by the degree of resistance among these organisms.