{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T15:09:07Z","timestamp":1772809747031,"version":"3.50.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"suppl_1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Limited data exist to guide physicians in the cost-effective treatment of acute exacerbation of chronic bronchitis (AECB). Therefore, the main objective of this study was to determine the antimicrobial efficacy and related costs for patients with AECB. A retrospective review of 60 outpatient medical records with a diagnosis of chronic obstructive pulmonary disease (COPD) and chronic bronchitis episodes from a pulmonary clinic of a teaching institution was undertaken. The participating patients had a total of 224 episodes of AECB requiring antibiotic treatment. Before review, empirical antibiotic choices were divided into first-line (amoxycillin, co-trimoxazole, tetracyclines, erythromycin), second-line (cephradine, cefuroxime, cefaclor, cefprozil) and third-line (co-amoxiclav, azithromycin, ciprofloxacin) agents. Patients receiving first-line agents failed significantly more frequently than third-line agents (19% vs 7%, P &amp;lt;0.05). Additionally, patients prescribed first-line agents were hospitalized significantly more often for AECB within 2 weeks of outpatient treatment as compared with patients prescribed third-line agents (18.0% vs 5.3% third-line agents; P &amp;lt;0.02). Time between subsequent AECB episodes requiring treatment was significantly longer for patients receiving third-line agents compared with first-line and second-line agents (P &amp;lt;0.005). Pharmacy costs were lowest with first-line agents (first-line US$10.30 \u00b1 8.76; second-line US$24.45 \u00b1 25.65; third-line US$45.40 \u00b1 11.11; P &amp;lt; 0.0001), but third-line agents showed a trend towards lower mean total costs of AECB treatment (first-line US$942 \u00b1 2173; second-line, US$563 \u00b1 2296; third-line, US$542 \u00b1 1946). The use of third-line antimicrobials, co-amoxiclav, ciprofloxacin or azithromycin, significantly reduced the failure rate and need for hospitalization, prolonged the time between AECB episodes, and showed a lower total cost for the management of AECB. Prospective studies are needed to confirm these findings.<\/jats:p>","DOI":"10.1093\/jac\/43.suppl_1.107","type":"journal-article","created":{"date-parts":[[2002,7,26]],"date-time":"2002-07-26T22:24:55Z","timestamp":1027722295000},"page":"107-113","source":"Crossref","is-referenced-by-count":83,"title":["Clinical and economic considerations in the treatment of acute exacerbations of chronic bronchitis"],"prefix":"10.1093","volume":"43","author":[{"given":"Christopher J.","family":"Destache","sequence":"first","affiliation":[{"name":"Schools of Pharmacy & Allied Health Professions and Medicine, Creighton University, Omaha, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naresh","family":"Dewan","sequence":"additional","affiliation":[{"name":"Schools of Pharmacy & Allied Health Professions and Medicine, Creighton University, Omaha, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter J.","family":"O'Donohue","sequence":"additional","affiliation":[{"name":"Schools of Pharmacy & Allied Health Professions and Medicine, Creighton University, Omaha, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Clayton","family":"Campbell","sequence":"additional","affiliation":[{"name":"Schools of Pharmacy & Allied Health Professions and Medicine, Creighton University, Omaha, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vito A.","family":"Angelillo","sequence":"additional","affiliation":[{"name":"Schools of Pharmacy & Allied Health Professions and Medicine, Creighton University, Omaha, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1999,3,1]]},"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/43\/suppl_1\/107\/37465782\/jac_43_suppl1_107.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/43\/suppl_1\/107\/37465782\/jac_43_suppl1_107.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T06:02:10Z","timestamp":1619589730000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/43\/suppl_1\/107\/2473533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,3,1]]},"references-count":0,"journal-issue":{"issue":"suppl_1","published-online":{"date-parts":[[1999,3,1]]},"published-print":{"date-parts":[[1999,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/43.suppl_1.107","relation":{},"ISSN":["1460-2091","0305-7453"],"issn-type":[{"value":"1460-2091","type":"electronic"},{"value":"0305-7453","type":"print"}],"subject":[],"published-other":{"date-parts":[[1999,3]]},"published":{"date-parts":[[1999,3,1]]}}}