Effect of Loracarbef and Amoxicillin on the Oropharyngeal and Intestinal Microflora of Patients with Bronchitis

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Abstract
The effect on the oropharyngeal and intestinal microflora and the efficacy and tolerance of loracarbef (200 mg b.i.d. for 7 days) versus amoxicillin (500 mg t.i.d. for 7 days) were compared in 80 patients with bronchitis. The oropharyngeal samples of 18% of patients in the amoxicillin group and 5% of patients in the loracarbef group revealed a new Gram-negative species around days 8-10. The presence of other aerobic bacteria than found at baseline in the faeces occurred in 38% of patients treated with amoxicillin compared with 31% in the loracarbef group on days 8-10. After treatment, no loracarbef- or amoxicillin-resistant aerobic Gram-negative bacteria were found in faecal samples in the loracarbef group, while amoxicillin- or loracarbef-resistant (E. coli) strains appeared in 35% of patients receiving amoxicillin (p < 0.001). Treatment success occurred by days 8-10 in all 40 patients receiving loracarbef, compared with 90% in the amoxicillin group, on days 21-28, in 93% and 90% respectively. The results of this study indicate that the use of loracarbef leads to minor changes in the normal oropharyngeal and intestinal microflora compared with amoxicillin, while almost no resistant Gram-negative bacteria emerge after treatment with loracarbef.