Efficacy and tolerance of roxithromycin versus clarithromycin in the treatment of lower respiratory tract infections.

In an open, randomized, parallel group study, the efficacy and tolerance of roxithromycin 300 mg po od was compared with clarithromycin 500 mg po bd in the treatment of 60 patients with lower respiratory tract infections (LRTI). The two groups were well-matched demographically. Fifty patients (25 per group) were clinically evaluable at the end of the study and a satisfactory response was found in 88% of those given roxithromycin and 80% of those given clarithromycin. All had received treatment for a minimum of 3 days. Only one (3.3%) of 30 patients in the roxithromycin group reported adverse events compared with seven (23.3%) of 30 in the clarithromycin group. Thus both roxithromycin and clarithromycin are effective in the treatment of LRTI but roxithromycin is better tolerated (P < 0.05) with the advantage of a once-daily dose.

Clinical and microbiological evaluation of pefloxacin in lower respiratory tract infections.

Patients with Gram-negative lower respiratory tract infections (acute exacerbation of chronic bronchitis (n = 23), pneumonia (n = 4), and bronchiectasis (n = 5) were treated with pefloxacin, 400 mg twice daily, given either intravenously or orally. Symptoms, signs and sputum volume and colour were monitored daily. Chest X-rays, sputum culture and Gram-stain examinations were carried out on days 1 and 5, and immediately after the end of the treatment. There was a clinical improvement, as indicated by the incidence of cough, dyspnoea and rales, and by sputum volume and colour in 31 patients (97%). Microbiological improvement, as indicated by the complete elimination of sputum pathogens and pus cells, was achieved in 28 of the patients (88%). In one patient, an adverse effect, renal failure, occurred. These results suggest that pefloxacin is both clinically and microbiologically effective for the treatment of Gram-negative lower respiratory tract infections.