Ciprofloxacin in acute exacerbations of chronic bronchitis

Thirty four patients with acute purulent exacerbations of chronic bronchitis were treated with 500 mg ciprofloxacin twice daily, orally, for ten days. The short-term response rate was 97% (cure 70.6%, improvement 26.4%) and failure 3%; the long-term response rate (six months follow-up) was 73.5%. Predominant initial pathogens were Haemophilus influenzae and Streptococcus pneumoniae, mostly in pure cultures. All sputum cultures except those with Str. pneumoniae became negative on the third day of treatment. Apart from a slower clearance of pneumococci from the sputum there were no significant differences in responses between pneumococcal and Haemophilus infections during and after therapy. Peak serum levels at 2 h after administration were 3.8 +/- 1.7 mg/l, half life was 3 h; peak sputum levels at 4 h were 1.3 +/- 0.95 mg/l. The serum-sputum penetration was 49.7% measured by AUC values. Mild adverse gastrointestinal effects were noticed in five patients.