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Penicillins vs. trimethoprim-based regimens for acute bacterial exacerbations of chronic bronchitis: a meta-analysis of randomised controlled trials

Abstract number: P838

Korbila I., Manta K., Siempos I., Dimopoulos G., Falagas M.

Objectives: Semi-synthetic penicillins (SSP) (amoxicillin, ampicillin, pivampicillin) and trimethoprim-based regimens [TMP, co-trimoxazole (TMP/SMX), TMP/sulfadiazine) have been used for the treatment of patients with acute bacterial exacerbations of chronic bronchitis (ABECB).

Methods: We searched MEDLINE, Current Contents, and the Cochrane Central Register of Controlled Trials to identify and extract data from relevant RCTs for a meta-analysis comparing the effectiveness and toxicity of penicillins with trimethoprim-based regimens.

Results: Out of 134 RCTs identified in the search, 5 RCTs, involving 287 patients, were included in the analysis. There was no difference between patients with ABECB treated with SSP compared to those treated with TMP, alone or in combination with a sulfonamide, regarding treatment success [intention to treat (ITT) patients: 262, odds ratio (OR)=1.68, 95% confidence intervals (CI) 0.91–3.09, clinically evaluable (CE) patients: 246, OR=1.59, 95% CI 0.79–3.20] or drug-related adverse events in general (186 patients, OR=0.37, 95% CI 0.11–1.24), diarrhoea, skin rashes, or withdrawals due to adverse events (179 patients, OR=0.27, 95% CI 0.07–1.03).

Conclusions: Based on limited evidence leading to wide confidence intervals of the estimated treatment effects, SSP and trimethoprim-based regimens seem to be equivalent in terms of effectiveness and toxicity for ABECB.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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