Ciprofloxacin in the treatment of acute exacerbations of chronic bronchitis.

Eighty hospital patients with acute purulent exacerbations of chronic bronchitis associated with Haemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis or Pseudomonas aeruginosa were treated with ciprofloxacin. The patients were divided into four groups of 20 patients each and administered either 500 mg, 750 mg (two different batches of tablets) or 1000 mg twice daily for ten days. Most of the patients with Haemophilus influenzae and Branhamella catarrhalis infections were treated successfully but the results in patients with Streptococcus pneumoniae and Pseudomonas aeruginosa infections were less satisfactory. Although the ciprofloxacin MICs for the latter organisms were relatively low, mean serum and sputum concentrations measured on the first day of treatment did not exceed 2-3 mg/l and 1-2.3 mg/l respectively. The overall clinical results for all dosage regimes were only fair, mainly due to failure to eradicate Streptococcus pneumoniae and Pseudomonas aeruginosa. Adverse effects (nausea, stomach pain or hallucinations) were seen in eight patients, causing treatment to be discontinued in five. It is concluded that ciprofloxacin is only of limited use in the treatment of respiratory tract infections unless Streptococcus pneumoniae is absent.