Clinical and bacteriological evaluation of cefaclor and tetracycline in acute episodes of bacterial bronchitis.

This report describes a single-blind, comparative evaluation of cefaclor and tetracycline therapy for acute episodes of bacterial bronchitis due to Hemophilus influenzae or Streptococcus pneumoniae. One therapeutic failure occurred in the 25 patients receiving cefaclor, and four occurred in the 26 patients receiving tetracycline. The latter failures were due to tetracycline-resistant organisms. Sputum cultures yielded 39 isolates of S pneumoniae and 11 of H influenzae. None of the isolates were resistant to cefaclor. In contrast, the incidence of resistance to tetracycline was 38% (18 of 48 isolates). All of the nine isolates of H influenzae tested were resistant to tetracycline; five of 11 H influenzae isolates were resistant to ampicillin, four of four were resistant to erythromycin, and five strains were resistant to multiple agents. These findings suggest that traditional therapy of bacterial bronchitis may be unsatisfactory in a substantial proportion of patients. The high cure rate and the absence of resistance found in the present study indicate that cefaclor is preferable to tetracycline in the treatment of bacterial bronchitis.