Airway hyperreactivity may contribute to acute, transient exacerbation experienced by patients with chronic obstructive pulmonary disease (COPD). It is well established that airway infections result in increased bronchospasm in response to inhaled methacholine and histamine. It is also known that gram-negative bacteria induce the release of histamine and deterioration of the pulmonary beta-adrenergic system in order to contribute to bronchial hyperreactivity in patients with COPD. The purpose of this study was to determine whether cefonicid, a long-acting cephalosporin that is active at low concentrations against Haemophilus influenzae and Streptococcus pneumoniae (the most frequently encountered causal bacteria in COPD), was able to block or reduce acute bronchospasm triggered by methacholine in 20 patients, ten affected with H influenzae-related infection and ten affected with S pneumoniae-related infection. After a seven-day course of treatment with cefonicid, the rate of bronchial hyperreactivity to methacholine, expressed as the provocative dose producing a 15% (PD15) fall in forced expiratory volume of the first second (FEV1)was changed: cefonicid significantly decreased the airway response to methacholine (the mean PD15 FEV1 was enhanced). The PD15 FEV1 rise after cefonicid was more accentuated (+9.4% vs +7.7%) in patients with H influenzae infection. Our data show that an antibiotic of proven efficacy must be indicated in the treatment of lower respiratory tract infection in patients with COPD where a gram-negative bacterium is suspected as a pathogen. Also, it is indicated because of its therapeutic implications on bronchial hyperreactivity.
|Number of pages||9|
|Journal||Current Therapeutic Research|
|Publication status||Published - 1989|
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