Efficacy of twice-daily amoxycillin/clavulanate in lower respiratory tract infections.

In this double-blind, double-dummy study, 324 patients with clinical evidence of community-acquired pneumonia (CAP) or an acute exacerbation of chronic bronchitis were randomly assigned to receive 10 days' treatment with either amoxycillin/clavulanate 875/125 mg twice daily or amoxycillin/clavulanate 500/125 mg three times daily. At the end of therapy, clinical success rates were 92.4% for the twice daily regimen and 94.2% for the three times daily regimen. There was no statistically significant difference between treatments (p = 0.647) and the 95% confidence interval around the treatment difference indicated that the two treatments were equivalent. Treatment equivalence was also confirmed at follow-up, four weeks after the end of treatment. Both regimens were well tolerated. In conclusion, amoxycillin/clavulanate 875/125 mg twice daily is as effective as amoxycillin/clavulanate 500/125 mg three times daily for the treatment of community-acquired lower respiratory tract infections and could improve patient compliance.

[Validation of a visual analog scale to measure dyspnea in patients with diffuse interstitial lung disease]. / Validación de una escala análoga visual para medir disnea en pacientes con enfermedad pulmonar intersticial difusa.

In order to validate a form of measuring dyspnea, a visual analog scale (VAS) was applied to 27 patients with different types of interstitial lung diseases (ILD). The test was done in two days with an interval of one month (dyspnea1 and dyspnea2). Additionally, the forced vital capacity (FVC) was obtained on these occasions (FVC1, FVC2). Nineteen patients with a recent diagnosis of ILD (RD) and eight with a previous diagnosis of ILD (PD) were included. In patients with RD, dyspnea1 correlated with FVC1 (r = -0.66, p < 0.01). A month after the initial treatment with steroids, dyspnea (mean +/- SD) decreased from 38 +/- 25 mm to 17 +/- 19 mm (p < 0.03), while the FVC increased from 1086 +/- 464 mL to 1350 +/- 536 mL (p < 0.05). Likewise, dyspnea2 correlated with FVC2 (r = -0.47, p < 0.05). As expected, patients with PD did not exhibit significant changes in the analysis of dyspnea on the second evaluation. The inter-observer coefficient of variation for the 8 patients with PD was of 5% and 9% for the first and second evaluations respectively, while the intraclass correlation coefficient was 0.92 and 0.91 respectively. The intra-observer coefficient of variation of two different observers was of 15% and 16% respectively, while the intraclass correlation coefficient was 0.69 and 0.62 respectively. These results suggest that the use of a VAS might be useful for the initial evaluation and during the follow-up of patients with ILD.