Acute exacerbations of chronic bronchitis: Fluoroquinolone clinical trial review

The role of antibiotics for treatment of acute exacerbations of chronic bronchitis has been controversial. At least 1 well-conducted placebo-controlled trial and the findings of a recent meta-analysis suggest that antibiotics are beneficial for some patients with acute bacterial exacerbations. The applicability of data from many older clinical trials is limited by the fact that they included patients without a confirmed bacterial etiology and that their study goal was to demonstrate equivalence, not differences, between 2 antibiotic regimens. Fluoroquinolone antibiotics are increasingly recognized as appropriate treatment options for patients with acute infectious exacerbations, especially in the current age of emergence of resistant lower respiratory tract pathogens to the beta-lactam, macrolide, and tetracycline classes of antibiotics. A review of recent fluoroquinolone clinical trials is presented.