A comparison of albuterol and erythromycin for the treatment of acute bronchitis

Journal of Family Practice, Nov, 1991 by William J. Hueston

Demographic information and characteristics of the patients' illnesses are shown in Table 1. The albuterol group had a greater proportion of male patients and an older mean age than the erythromycin group, although neither of these differences was statistically significant. The albuterol group also had a greater proportion of smokers than the erythromycin group (65% vs 35%, P = .09); the average number of packs per day smoked by those who did smoke, however, was similar in both groups.

The patients were also well matched in the severity and characteristics of their illness (Table 1). Patients in both groups had a similar duration of cough. Also, the number of patients with a night cough or purulent sputum (defined as yellow, green, brown, or bloody sputum that was thick in consistency) and the number of patients who reported other symptoms were comparable between groups. In addition, there was no difference in the percentage of patients who had abnormalities on initial physical examination.

After 7 days of therapy, it was found that 7 patients (41%) in the albuterol group were still coughin compared with 15 patients (88%) in the erythromycin group (P = .004) (Table 2). Furthermore, fewer patients in the albuterol group reported a productive cough (35% vs 71%, P = .002). The number of patients who still had purulent sputum or night cough, however, was similar between the two groups. Also the number of patients with abnormal lung examinations after 7 days of medications was similar, although slightly higher in the albuterol group (P = .61).

Because the two groups differed in the percentage of patients who were smokers, a subanalysis was performed based on this variable. This analysis produced data similar to the results for the entire group. Among smokers, five patients (45%) in the albuterol group and six patients (100%) in the erythromycin group were still coughing after 7 days of therapy (P = .03); in nonsmokers, one patient (17%) in the albuterol group and nine patients (82%) in the erythromycin group were still coughing (P = .02). In comparing smokers and nonsmokers in the same treatment regimen, there was no significant difference between the percentage still coughing in either the albuterol group (P = .25) or the erythromycin group (P = .28).

Analysis of the patients' symptoms diaries showed that the coughing diminished and the general feeling of well-being in patients in the albuterol group tended to improve slightly sooner than in patients in the erythromycin group, although the results are not statistically significant (Table 3). Although patients in the albuterol group reported feeling better quicker, there was no difference between the albuterol and erythromycin groups in the overall improvement in their feeling of well-being during the course of therapy ( 0.9 vs 1.4, respectively). There was also no difference between treatment groups in the mean number of days that patients missed work or limited their activity secondary to their illness. Patients in both groups were also equally likely to use over-the-counter medications.