Abstract The efficacy and tolerability of cefpodoxime proxetil were evaluated in 29 patients over 65 years of age with a diagnosis of acute exacerbation of chronic bronchitis or community-acquired pneumonia. In this open, comparative, randomized study, patients were treated with cefpodoxime proxetil 200 mg twice daily or a combination of amoxicillin/clavulanic acid 500/125 mg three times daily for 5 to 10 days. The patients were evaluated at the beginning and end of the treatment period and 25 to 40 days after the treatment ended. The causative organism was isolated in 17 (59%) of the 29 patients. No statistically significant differences were reported between the two groups regarding the number of isolates, bacterial sensitivity, or inhibition halo diameter. The percentages of satisfactory clinical responses at the end of the treatment were 100% for the cefpodoxime proxetil group and 73% for the amoxicillin/clavulanic acid group. This difference was statistically significant ( P = 0.05). There were no therapeutic failures in the cefpodoxime proxetil group, but 27% of the patients in the amoxicillin/clavulanic acid group experienced therapeutic failure ( P = 0.04). Thus cefpodoxime proxetil was shown to be superior to amoxicillin/clavulanic acid in the treatment of acute exacerbations of chronic bronchitis or pneumonia in elderly patients.