Short-course Fluoroquinolones in Acute Exacerbations of Chronic Bronchitis

Mark H Gotfried; Ronald F Grossman

Disclosures

Expert Rev Resp Med. 2010;4(5):661-672. 

In This Article

Antimicrobial Therapy for AECB

Successful management of AECB involves appropriate selection and use of antibiotic agents and adjunctive treatments, including removal of irritants; hydration; utilization of oxygen, corticosteroids and bronchodilators; and chest physical therapy.[3,5,15] Antimicrobial therapy can be effective in the treatment of AECB, leading to improvement in peak expiratory flow rates, fewer hospitalizations, lower relapse rates and a higher percentage of clinical successes.[1,16–18]

Current guidelines for antimicrobial therapy in patients with AECB have been established by the Global Initiative for Chronic Obstructive Lung Disease (GOLD),[101] the American Thoracic Society,[102] the Canadian Thoracic Society, the Canadian Infectious Disease Society,[3,19] the European Respiratory Society[20] and a consensus statement formulated by Spanish medical societies.[21]

A series of broad-spectrum antibacterial agents, such as amoxicillin, trimethoprim–sulfamethoxazole and doxycycline, have been traditionally used as first-line treatment options for patients with mild AECB and no additional risk factors.[3,10] Alternative antibacterials, including β-lactams/β-lactamase inhibitors, cephalosporins and macrolides, have been recommended in treatment guidelines as first-line treatment options for patients with mild-to-moderate AECB.[10]

The respiratory fluoroquinolones include levofloxacin, moxifloxacin and gemifloxacin and have been recommended as a first-line treatment for AECB in patients who have chronic bronchitis complicated by comorbid illness, severe obstruction with forced expiratory volume in 1 s (FEV1) less than 50%, old age (>65 years) or those who have recurrent exacerbations.[3,4,10]

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....