Sputum colour as marker for clinical success in patients with acute exacerbation of chronic bronchitis (AECB) treated with levofloxacin
Abstract number: 902_p457
Bacterial exacerbations of chronic bronchitis are an ongoing therapeutic challenge with increasing incidence in elderly patients. Levofloxacin, due to its enhanced activity against the most common pathogens in AECB, is well accepted as a standard treatment for this indication. The objective was to investigate efficacy and safety in AECB-patients, documented by signs, symptoms and sputum colour.
In a post authorisational survey during the season 2002/2003 a total of 1.297 outpatients (median age 59.8 years) were treated with Levofloxacin 500 mg tablets o.d. for 7 days. 1.228 patients suffered from AECB. Concomitant diseases were documented in 49% and concomitant medication for 69% of the patients. Two AECB episodes (median) occurred during the previous 12 months with a median time interval of 15 weeks between the previous and the actual episode. The change of sputum colour characterised by a pretrial defined colour table based on the Stockley criteria was documented by the patients on a daily basis during the treatment.
A purulent sputum was found in 95% of the 1.228 patients before treatment, but at the end of treatment in only 15% (P < 0.001). For 1.034 patients sputum colour was rated. At day 5 a change from green/dark yellow to clear/white was observed in 45% of the patients and in 76% at day 7, end of treatment. Body temperature decreased in 94%, improvement was observed for cough in 93%, for breathing difficulties in 83%, for auscultation findings in 88%, and for general physical condition in 86% of the patients (each P < 0.001). At the end of observation the clinical outcome was rated as successful in 98% of the patients (60% cured, 38% improved). A complete release of symptoms was reached after 6.6 days (mean) and normal everyday activities were resumed after 6.9 days (mean).Adverse drug reactions were reported in only two patients (0.15%).
The clinical outcome of a 7-day treatment with Levofloxacin, assessed by signs, symptoms and the change of sputum colour as an additional marker, demonstrates a high efficacy in the present population of elderly AECB-patients with various concomitant diseases, accompanied by an excellent safety profile, resulting in a subsequent resumption of normal activities at the end of treatment."
|Session name:||XXIst ISTH Congress|
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