Pilot study of factors associated with exacerbations in chronic bronchitis

The factors associated with exacerbations of chronic bronchitis were investigated in a pilot study of 23 male patients over a period of 29 months. There were 63 exacerbations—56 were fully investigated and in seven only serological studies were possible. Evidence of the presence of an infective agent was sought in the early stages of the exacerbations and during relative quiescence. Significantly more potential pathogens, both bacterial (pneumococci and Haemophilus influenzae) and viral and mycoplasmal, were found during exacerbations than in quiescent periods. It was not possible to demonstrate that atmospheric pollution or low temperature influenced exacerbations, but the data are insufficient to exclude a small effect.It is emphasized that the value of future work on these lines would be increased if agreement could be reached on the definition of an exacerbation.     

Rapid diagnosis of exacerbations of chronic bronchitis of pneumococcal etiology in children

The diagnostic possibilities of the microscopic examination of bronchial secretion smears, stained by Gram's method, from 56 children with chronic bronchitis at different stages of exacerbation have been studied. The following criteria have been proposed for confirming the etiological role of pneumococci in cases of endobronchitis in children: the number of paired diplococci in the visual field must exceed 10 with polynuclears covering the whole field. In 84% of cases the use of this method makes it possible to determine the pneumococcal etiology of the disease within two hours from the arrival of the pathological material to a bacteriological laboratory; this method can also be used for evaluating the effectiveness of antibacterial therapy at its different stages.     

Single-blind comparative trial of trimethoprim-sulphamethoxazole and ampicillin in the treatment of exacerbations of chronic bronchitis

Fifty patients with exacerbations of chronic bronchitis were treated with either a combination of trimethoprim 320 mg. and sulphamethoxazole 1,600 mg. a day or ampicillin 2 g. a day. The trial, carried out as a single-blind procedure, showed that the combination was more effective as judged by clinical response and reduction in sputum volume and purulence, with eradication of pathogenic organisms. No appreciable side-effects were encountered with either treatment, and it is suggested that the trimethoprim-sulphamethoxazole combination may be a safe and useful drug in the treatment of chronic bronchitis.     

Efficacy and safety of moxifloxacin in acute exacerbations of chronic bronchitis: a prospective, multicenter, observational study (AVANTI)

Background

Acute exacerbations of chronic bronchitis (AECB), including chronic obstructive pulmonary disease (AECOPD), represent a substantial patient burden. Few data exist on outpatient antibiotic management for AECB/AECOPD in Eastern/South Eastern Europe, in particular on the use of moxifloxacin (Avelox®), although moxifloxacin is widely approved in this region based on evidence from international clinical studies.

Methods

AVANTI (AVelox® in Acute Exacerbations of chroNic bronchiTIs) was a prospective, observational study conducted in eight Eastern European countries in patients?>?35 years with AECB/AECOPD to whom moxifloxacin was prescribed. In addition to safety and efficacy outcomes, data on risk factors and the impact of exacerbation on daily life were collected.

Results

In the efficacy population (N?=?2536), chronic bronchitis had been prevalent for?>?10 years in 31.4% of patients and 66.0% of patients had concomitant COPD. Almost half the patients had never smoked, in contrast to data from Western Europe and the USA, where only one-quarter of COPD patients are non-smokers. The mean number of exacerbations in the last 12 months was 2.7 and 26.3% of patients had been hospitalized at least once for exacerbation. Physician compliance with the recommended moxifloxacin dose (400 mg once daily) was 99.6%. The mean duration of moxifloxacin therapy for the current exacerbation (Anthonisen type I or II in 83.1%; predominantly type I) was 6.4?±?1.9 days. Symptom improvement was reported after a mean of 3.4?±?1.4 days. After 5 days, 93.2% of patients reported improvement and, in total, 93.5% of patients were symptom-free after 10 days. In the safety population (N?=?2672), 57 (2.3%) patients had treatment-emergent adverse events (TEAEs) and 4 (0.15%) had serious TEAEs; no deaths occurred. These results are in line with the known safety profile of moxifloxacin.

Conclusions

A significant number of patients in this observational study had risk factors for poor outcome, justifying use of moxifloxacin. The safety profile of moxifloxacin and its value as an antibiotic treatment were confirmed. Physicians complied with the recommended 400 mg once-daily dose in a large proportion of patients, confirming the advantages of this simple dosing regimen.

Trial registration

ClinicalTrials.gov identifier: NCT00846911     

The use of hypoxic stimulation in chronic and relapsing bronchitis in young children ]

214 children of different age with various forms of bronchitis were subject to immunological and biochemical examination. Against a background of hypoxic state of patients the values of quantitative indices of cellular immunity (E-RFC, blast-transformation reaction with phytohemagglutination) were revealed to decrease and dysimmunoglobulinemia-to form. It is shown that in the period of exacerbation of clinical symptoms of bronchitis the concentration of malonic dialdehyde and resistance of erythrocyte membranes to peroxide hemolysis significantly increase. Analysis of peroxidation level against a background of improvement of clinical indices after the performed treatment indicates that there is no tendency to normalization of metabolic disorders. The above results show that it is necessary to carry out normobaric hypoxic stimulation aimed at treating and preventing bronchitis in children of early age.     

Pneumoconiosis and chronic bronchitis.

Data from a major long-term epidemiological survey in the British coalmining industry were examined to determine whether bronchitis offered any protective action against the development of pneumoconiosis. No evidence of such an effect was found.     

Use of antibiotics and nitrofurans in treating acute and chronic cholecystitis

Sixty-two patients with acute cholecystitis and 108 patients with chronic calculous cholecystitis were examined. High levels of contamination of the bile, gallbladder mucosa and gallstones were shown. E. coli, Staphylococcus and Streptococcus were most frequent among 20 species of aerobic and anaerobic bacteria. Preoperative sanation of the hepatoduodenal area with antibiotics did not result in complete elimination of the bacteria in the bile, gallbladder mucosa and gallstones. The use of nitrofurans and especially furazolidone and furagin in the preoperative period prevented the microbial growth in the specimens collected during the operations. The data of the study allow recommending the use of furazolidone and furagin for preoperative sanation of the biliferous tract.