Comparative Safety and Efficacy of Clarithromycin and 3 Oral Cephalosporins in the Treatment of Outpatients with Bacterial Bronchitis due to Haemophilus influenzae

A pooled analysis of 3 double-blind randomised trials comparing clarithromycin (500mg twice daily; n = 63) with either cefuroxime axetil (500mg twice daily), cefaclor (500mg 3 times daily) or Cefixime (400mg once daily; total n = 72) in the treatment of bacterial bronchitis due to Haemophilus influenzae was performed. For evaluable patients, successful clinical outcome (cure or improvement) was noted for 55 of 60 clarithromycin-treated patients (92%) and 62 of 65 cephalosporin-treated patients (95%) [p = 0.479]. Clinically significant improvements in signs and symptoms were also comparable between treatment groups, as was eradication of H. influenzae, which occurred in 51 of 60 (85%) and 57 of 65 (88%) of clarithromycin and cephalosporin recipients, respectively (p = 0.795). 22 patients in the clarithromycin group (35%) and 20 in the cephalosporin group (28%) reported adverse events (p = 0.457). The majority of these were mild or moderate in severity and were digestive system-related in both groups. Thus, the new macrolide clarithromycin appears to be effective and well tolerated in the treatment of patients with bacterial bronchitis caused by H. influenzae.