Clinical efficacy and safety of topical antibacterial therapy in exacerbations of chronic bronchitis and chronic obstructive pulmonary disease

Chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD) are among the most common respiratory diseases and are associated with high morbidity and significant disability. Frequent exacerbations of COPD lead to prolonged deterioration in respiratory function and gas exchange, faster disease progression, a significant decrease in the quality of life, and significant treatment costs. The most affordable and effective local therapeutic agent is inhaled aerosol of thiamphenicol glycinate acetylcysteinate (TGA). However, there is insufficient data in the international and domestic literature on using this drug in real clinical practice.

The aim of this study was to evaluate the clinical and pharmacoeconomic efficacy of TGA compared with systemic antibacterial drugs in the treatment of exacerbations of CB and COPD.

Methods. A retrospective analysis of medical records was carried out, including a total of 1,151 cases of exacerbations of CKD and COPD diagnosed and treated at the Chelyabinsk Regional Pulmonological Center in 2020 – 2024. The clinical and pharmacoeconomic efficacy was evaluated.

Results. The use of the topical antibacterial drug TGA (Fluimucil antibiotic IT®) makes it possible to achieve remission in patients with infectious exacerbations of CB and COPD and increase the time interval to the next exacerbation by 28.09 days (95% CI – 16.57 – 39.6 days, p < 0.01) compared with systemic antimicrobial drugs. The use of TGA leads to a rapid decrease in the main symptoms of exacerbation (decreased cough, shortness of breath, and sputum production). The use of TGA reduces the economic cost per patient, thus reducing the economic burden of CB and COPD.

Conclusion. The use of TGA in clinical practice helps reduce the frequency of exacerbations, increase the time to the next exacerbation and increase the effectiveness of antibacterial therapy, while reducing the costs.

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