Amoxycillin/clavulanate in acute purulent exacerbations of chronic bronchitis

• Published in: Journal of antimicrobial chemotherapy 1987-03, Vol.19 (3), p.373-383
• Main Authors: Maesen, F. P. V., Davies, B. I., Baur, C.
• Format: Article
• Language: English
• Subjects: Aged; Amoxicillin - metabolism; Amoxicillin - pharmacology; Amoxicillin - therapeutic use; Amoxicillin-Potassium Clavulanate Combination; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Infections - drug therapy; beta-Lactamase Inhibitors; Biological and medical sciences; Bronchitis - drug therapy; Chronic Disease; Clavulanic Acids - metabolism; Clavulanic Acids - pharmacology; Clavulanic Acids - therapeutic use; Drug Combinations - metabolism; Drug Combinations - pharmacology; Drug Combinations - therapeutic use; Female; Haemophilus Infections - drug therapy; Haemophilus influenzae - drug effects; Humans; Kinetics; Male; Medical sciences; Middle Aged; Moraxella - drug effects; Moraxella - enzymology; Pharmacology. Drug treatments; Recurrence; Sputum - metabolism; Sputum - microbiology; Streptococcal Infections - drug therapy; Streptococcus pneumoniae - drug effects
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/19.3.373

Twenty patients, all admitted to hospital with acute purulent exacerbations of chronic bronchitis associated with Haemophilus influenzae, Streptococcus pneumoniae or β-lactamase producing Branhamella catarrhalis were treated twice daily for ten days with amoxycillin/clavulanate. Ten patients were first given 1000 mg amoxycillin with 200 mg potassium clavulanate intravenously bd for three days, before crossing to the standard oral regimen of 1000 mg amoxycillin + 250 mg potassium clavulanate bd. Clinical results on day 10 were excellent in 16/20 patients, but 14 patients developed recurrences or reinfections within a week of the end-of-treatment, five of them with β-lactamase producing B. catarrhalis. Bacteriological and kinetic studies showed that the branhamella β-lactamases were inhibited by 0.25 mg/1 clavulanic acid and that the mean sputum concentration of clavulanic acid was 0.16 mg/1, that of amoxycillin being 0.92 mg/1. The importance of the follow-up of such infections is stressed.