Open Randomized Study Comparing Doxycycline and Co-Amoxiclav in the Treatment of Acute Suppurative Tracheobronchitis in Adults

Abstract

Doxycycline and co-amoxiclav were compared in a randomized clinical trial involving adult patients with acute suppurative tracheobronchitis. Patients were treated for 5 to 10 days with either antibiotic following three schemes: co-amoxiclav 500 mg three times daily, or doxycycline 200 mg on day 1 followed by 100 mg daily, or 200 mg daily. Assessment after 5 – 9 days was based only on clinical parameters. Patients with inadequate response to the initial treatment were crossed over to the alternative antibiotic. Of the 210 patients enrolled, 206 were available for evaluation of efficacy. Both antibiotic regimens proved equally efficacious, with rates of clinical response (cure or improvement) of 89% and 91% for doxycycline and co-amoxiclav, respectively. Patients who were crossed over to the alternative antibiotic had a significantly lower cure rate after their second course of antibiotics (22% compared with 70%). Adverse effects, most often of gastro-intestinal origin, were more common in the co-amoxiclav group than in the doxycycline-treated group, but rarely caused cessation of treatment.