Augmentin (intravenous then oral) compared with cefuroxime followed by cephalexin for chest infections in hospitalised patients

Abstract

SummaryAugmentin and cefuroxime were compared in the treatment of chest infections in hospital patients in a multicentre study. One hundred and six patients were randomly allocated to 48 hours treatment with intravenous Augmentin, (amoxycillin 1g + clavulanic acid 200mg), every eight hours. Sixty eight patients received cefuroxime (750mg) intravenously every eight hours. Patients receiving intravenous Augmentin were then given five days oral treatment with Augmentin. Patients receiving cefuroxime were subsequently given five days oral treatment with cephalexin. For severely ill patients, the intravenous phase of treatment was extended from 48 to 96 hours.There was no significant difference in the numbers of patients showing a good overall response to the two therapies at 48 hours. However, at Day 7 significantly more patients were clinically improved or cured after receiving Augmentin as opposed to those taking cefuroxime/cephalexin.There were no significant differences between treatment groups when analysed by indication or by key sign or symptom.At the start of treatment bacterial organisms were isolated from the sputum of 29/87 (33 per cent) of patients who received Augmentin and from 19/48 (40 per cent) of patients producing sputum who received cefuroxime. Both treatment regimens proved effective against the organisms isolated at the start of treatment. At the end of treatment all of these organisms had been eradicated by Augmentin and 91 per cent had been eradicated by the cefuroxime/cephalexin regimen.Both treatments were well tolerated, with no significant difference between treatments in the small number of adverse events noted.Augmentin and cefuroxime have been shown to be similarly effective and well tolerated treatments for chest infection. In addition, it is shown that Augmentin has advantages in terms of speed of response and it is available as both intravenous and oral formulations. Thus, Augmentin would be a suitable first choice antibiotic for the treatment of lower respiratory tract infections.