Combination of sulbactam pivoxyl and bacampicillin in acute exacerbations of chronic bronchitis

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Abstract
Twenty patients with acute exacerbations of chronic bronchitis were treated with the combination of 750 mg sulbactam pivoxil (CP-47,904) and 800 mg bacampicillin orally, twice daily for 10 days. The infections were caused mainly by Haemophilus influenzae, Streptococcus pneumoniae and Branhamella catarrhalis; 5 patients had .beta.-lactamase-forming infecting strains. Cultures were repeated on days 10 and 17. Peak blood concentration of ampicillin (mean 12.1 mg/l) were found 1.6 h after the first dose; mean sputum peak concentration was 0.22 mg/l. The peak concentration of .beta.-lactamase inhibitor in the blood was found 1.8 h after dosage and averaged 7.2 mg/l. Sputum concentrations of sulbactam were less than the lower limit of sensitivity of the assay method (0.5 mg/l) in all but 1 patient. The penetration of ampicillin from blood to sputum was .apprx. 3%. The clinical results were encouraging, as 15 of the 19 evaluable patients yielded excellent or good results on day 17. One patient developed severe nausea and another had severe diarrhea; one patient dropped out because of a hypersensitivity rash.