Beneficial Effect of Early Intervention with Garenoxacin for Bacterial Infection-Induced Acute Exacerbation of Bronchial Asthma and Chronic Obstructive Pulmonary Disease

Int Arch Allergy Immunol. 2019;178(4):355-362. doi: 10.1159/000495761. Epub 2019 Feb 13.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) and asthma have similar clinical features and are both exacerbated by airway infection.

Objective: To determine whether garenoxacin mesylate hydrate (GRNX) added to the standard care for bacterial infection-induced acute exacerbation of asthma or COPD in adults has clinical benefits.

Method: This single-arm clinical trial was conducted from January 2015 to March 2016. Adults with a history of asthma or COPD for more than 12 months were recruited within 48 h of presentation with fever and acute deterioration of asthma or COPD requiring additional intervention. Participants were administered 400 mg GRNX daily for 7 days without additional systemic corticosteroids or other antibiotics. The primary outcome was efficacy of GRNX based on clinical symptoms and blood test results after 7 days of treatment. Secondary outcomes were: (1) comparison of the blood test results, radiograph findings, and bacterial culture surveillance before and after treatment; (2) effectiveness of GRNX after 3 days of administration; (3) analyzation of patient symptoms based on patient diary; and (4) continued effectiveness of GRNX on 14th day after the treatment (visit 3).

Results: The study included 44 febrile patients (34 asthma and 10 COPD). Frequently isolated bacteria included Moraxella catarrhalis (n = 6) and Klebsiella pneumoniae (n = 4). On visit 2, 40 patients responded, and no severe adverse events were observed. All secondary outcomes showed favorable results.

Conclusion: GRNX effectively treated asthma and COPD patients with acute bacterial infection without severe adverse events. Further research with a larger study population is needed.

Keywords: Antibiotics; Asthma; Chronic obstructive pulmonary disease; Chronic respiratory disease; Early intervention; Exacerbation; Garenoxacin.

MeSH terms

  • Acute Disease
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Asthma / drug therapy*
  • Bacteria / isolation & purification
  • Bacterial Infections / complications*
  • Bacterial Infections / drug therapy
  • Female
  • Fluoroquinolones / adverse effects
  • Fluoroquinolones / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • garenoxacin