Erythromycin and bromhexine in acute exacerbations of chronic bronchitis. A study on sputum penetration and clinical effectiveness.

A group of 22 patients with acute purulent exacerbations of chronic bronchitis were treated with 1 g erythromycin ethyl succinate granules twice daily orally for 10 days. Half the patients were given bromhexine additionally and the other half received placebo instead. Serum and sputum erythromycin concentrations were measured microbiologically at intervals after the first dose. The clinical results in both treated groups were rather poor, with many patients becoming infected again immediately after the chemotherapy. Blood and sputum concentrations of erythromycin did not greatly differ in the two patient groups. The sputum concentration of erythromycin was often higher than the blood concentration at the same time. The MIC's of erythromycin (in particular, those for the Haemophilus influenzae strains) were often higher than the drug concentrations attained in the sputum.