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

Short-course Fluoroquinolone Therapy

Rapid recovery from AECB may decrease overall costs and improve work productivity.[22,23] Increased speed of recovery from AECB with antibiotic therapy reduces time lost from work.[13] The requirement for hospitalization and length of stay are important cost-drivers associated with AECB, and treatment that produces rapid resolution of symptoms has the potential to decrease these costs.[2]

A number of studies using different classes of antibiotics, including fluoroquinolones,[24–35] have been conducted to compare the efficacy of different time courses of antibiotic therapy in the treatment of AECB. Results from these studies all demonstrated that comparable clinical resolution can be attained with a shorter course (≤5 days) of antimicrobial treatment compared with commonly prescribed standard therapy (≥7 days).

Fluoroquinolones exhibit a broad spectrum of antibacterial activity that includes most AECB-causing pathogens.[13,36] Fluoroquinolones are concentration-dependent killers, and are not dependent on the half-life of the drug, thus providing a rationale for studying their effectiveness using a shorter course of therapy. US FDA-approved antibiotic regimens for the treatment of AECB include moxifloxacin 400 mg once daily for 5 days; gemifloxacin 400 mg once daily for 5 days; and levofloxacin 500 mg once daily for 7 days. This article reviews the studies that compared clinical efficacy and speed of recovery for short-course fluoroquinolone therapy with traditional therapy in the management of AECB.

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