Trimethoprim-Sulfamethoxazole in the Treatment and Prevention of Purulent Exacerbations of Chronic Bronchitis

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Abstract
In the treatment of purulent exacerbations of bronchitis, the usually recommended dose of trimethoprim-sulfamethoxazole (TMP-SMZ) was inadequate. Treatment with 480 mg of TMP and 2,400 mg of SMZ daily was very successful. Compared with 2,000 mg of tetracycline hydrochloride daily in a double-blind trial in 197 patients, this dose of TMP-SMZ seemed superior in reducing purulence of the sputum and improving the clinical state of the patient. It was significantly better in preventing deterioration, both during and up to a month after treatment. In the prevention of purulent exacerbations of chronic bronchitis, 40 hospital inpatients with advanced chronic bronchitis were given 320 mg of TMP and 1600 mg of SMZ daily for 10 weeks. In a strictly double-blind trial their progress was compared with that of 20 patients given a placebo for 10 weeks. Highly significant clinical and bacteriologic differences favored the patients given chemotherapy. Side-effects were minimal, and tolerance was excellent. The combination of TMP and SMZ in the above doses should be one of the first choices of chemotherapeutic agents in the treatment and prophylaxis of chronic purulent bronchitis.

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