Clinical efficacy of brodimoprim in the treatment of acute exacerbation of chronic bronchitis - A meta-analysis

Brodimoprim is a diaminopyrimidine with a broad spectrum of antimicrobial activity in vitro, which includes activity against most common lower respiratory tract pathogens. The relative clinical efficacy of this agent was assessed in a meta-analysis of 16 randomised nonblind studies in more than 450 patients with acute exacerbations of chronic bronchitis. Physician-rated global clinical efficacy with brodimoprim was greater than with amoxicillin, and equivalent to that evinced for doxycycline. There was no evidence of intergroup differences in this measure between patients receiving brodimoprim and ampicillin or cefaclor, but equivalence was unproven. Overall, global clinical efficacy tended to favour brodimoprim in comparison with all other agents. Brodimoprim was as well tolerated as comparator agents when the results of studies using the same drugs were pooled (brodimoprim Is amoxicillin, ampicillin, cefaclor or doxycycline) or results of all studies were combined (brodimoprim vs all reference drugs). However, it was not possible to prove equivalence of tolerability in any of these comparisons because of the small number of patients. Based on these results, brodimoprim is a useful alternative to standard antimicrobial agents in the treatment of patients with acute exacerbations of chronic bronchitis.