Chodosh S, Tuck J, Pizzuto D
Pulmonary Medicine, Veterans Administration Outpatient Clinic, Boston, Massachusetts 02118.
Scand J Infect Dis Suppl. 1988;53:22-8.
The comparative efficacy of doxycycline versus amoxicillin, cephalexin, cefaclor and enoxacin was examined in four separate cross-over and blinded studies of acute bacterial bronchitis in chronic bronchitis and asthma. The efficacy of doxycycline over the eleven-year period (1975-1986) covered by these studies also was examined. Patients with acute bacterial exacerbations, defined by increased chest symptoms, increased bacteria and sputum neutrophilia, were randomly entered. When a new acute infection occurred, they were re-entered and received the other antibacterial. Response was recorded as successful or not; early rebound infections and the periods free of infection were noted. A total of 136 exacerbations were evaluated in the comparison of doxycycline with the other 4 antibacterials, and 93 exacerbations in the long-term efficacy of doxycycline. The acute success was similar for doxycycline with the other antibacterials and was superior to cefaclor. Early rebound infections occurred less frequently with doxycycline as compared to the cephalosporins and was similar versus amoxicillin and enoxacin. The infection-free period was longer after doxycycline than with the other four antimicrobials. Doxycycline maintained its efficacy to elicit a prompt response and provide a long infection-free period, but an increase of early rebound infections was noted over the eleven-year period.
在四项针对慢性支气管炎和哮喘患者急性细菌性支气管炎的独立交叉双盲研究中，对多西环素与阿莫西林、头孢氨苄、头孢克洛和依诺沙星的疗效进行了比较。还考察了这些研究涵盖的十一年期间（1975 - 1986年）多西环素的疗效。以胸部症状加重、细菌增多和痰液中性粒细胞增多为定义的急性细菌性加重患者被随机纳入研究。当发生新的急性感染时，他们再次进入研究并接受另一种抗菌药物治疗。记录反应是否成功；注意早期反弹感染和无感染期。在多西环素与其他4种抗菌药物的比较中，共评估了136次加重情况，在多西环素的长期疗效方面评估了93次加重情况。多西环素与其他抗菌药物相比，急性治疗成功率相似，且优于头孢克洛。与头孢菌素相比，多西环素引起的早期反弹感染频率较低，与阿莫西林和依诺沙星相似。多西环素治疗后的无感染期比其他四种抗菌药物更长。多西环素能够维持其迅速起效并提供较长无感染期的疗效，但在十一年期间，早期反弹感染有所增加。
