Author/Editor		Letonja, Saša
Title		Akutna eksacerbacija kroničnega bronhitisa - sodobni pogledi in lastne izkušnje
Translated title		Acute exacerbation of chronic bronchitis - current concepts and our own experience
Type		članek
Source		Krka Med Farm Supl
Vol. and No.		Letnik 20, št. Suppl 2
Publication year		1999
Volume		str. 36-46
Language		slo
Abstract		Forty patients admitted to hospital due to acute exacerbation of chronic bronchitis were included in an open, comparative, prospective, randomised clinical study. Included were patients aged between 33 and 65. Ninety-three percent of the patients were males. Fifteen percent of the patients were smokers and 60% of them presented with accompanying diseases. The patients had chronic obstructive pulmonary disease (COPD) of mild to moderate severity. The majority of the patients (78%) expirienced two to three acute exacerbations of the disease in the previous year and had chronic bronchitis for less than ten years (95%). The first group of patients (22 patients) was treated with 500 mg of clarithromycin (Fromilid) twice daily and the second group (18 patients) received a combination of amoxicillin and clavulanic acid in a dose of 1000 mg twice daily. The groups of patiens were homogenous according to all clinical and laboratory parameters. Prior to the treatment, sputum samples were collected for the microbiolagical analysis. The most frequently isolated pathogens were S. pneumoniae, and H. influenzae in the group of clarithromycin treated patients and M. catarrhalis H. influenzae in the group of patiens receiving the reference medication. At the end of the treatment period of 11 days on average, disease-producing bacteria were isolated in 2 patients of the clarithromycin group and 4 patients receiving the amoxicillin clavulanic acid combination. Three to four weeks later, disease-producing bacteria were isolated in a single patient who was with clarithromycin. (Abstract truncated at 2000 characters.)
Summary		V prospektivni odprti primerjalni randomizirani klinični raziskavi smo zaradi akutnih eksacerbacij kroničnega bronhitisa bolnišnično zdravili 40 bolnikov. V raziskavo smo vključili bolnike, stare od 33 do 65 let. 93 % je bilo moških, 15 % je bilo kadilcev, 60 % bolnikov je imelo tudi spremljajoče bolezni. Bolniki so imeli blago do zmerno hudo kronično obstruktivno pljučno bolezen (KOPB). Večina bolnikov (78 %) je imela v prejšnjem letu dve do tri akutne eksacerbacije, kronični bronhitis pa manj kot deset let (95 %). Skupina 22 bolnikov je dobivala po 500 mg klaritromicina (Fromilida) dvakrat na dan, druga skupina, v njej je bilo 18 bolnikov, pa kombinacijo amoksicilina in klavulanske kisline, in sicer 1000 mg dvakrat na dan. Skupini bolnikov sta bili enakovredni po vseh merjenih kliničnih in laboratorijskih merilih. Pred zdravljenjem smo odvzeli vzorce izmečka za mikrobiološko anallzo. V skupini bolnikov, ki smo jih zdravili s klaritromicinom, sta bila najpogostejša povzročitetja S. pneumoniae in H. influenzae, v skupini bolnikov, ki so dobivali primerjalno zdravilo, pa M. catarrhalis in H. influenzae. Po končanem zdravljenju, ki je v obeh skupinah trajalo povprečno 11 dni, smo izolirali patogene bakterije pri dveh bolnikih, ki smo jih zdravili s klaritromicinom, in pri štirih bolnikih, ki so dobivali amoksicilin s klavulansko kislino, tri do štiri tedne po koncu zdravljenja pa le še pri enem bolniku, ki smo mu dajali klaritromicin. Klinično stanje se je bistveno izbolšalo pri 72%, blago pa pri 22%. Zdravljenje je bilo neučinkovito pri 6%.(Izvleček prekinjen pri 2000 znakih.)
Descriptors		BRONCHITIS ANTIBIOTICS CHRONIC DISEASE CLARITHROMYCIN AMOXICILLIN CLAVULANIC ACIDS COUGH SPUTUM DYSPNEA LEUKOCYTE COUNT TREATMENT OUTCOME