COMPARATIVE EFFICACY AND TOLERABILITY OF CLARITHROMYCIN AND CEFACLOR IN THE TREATMENT OF OUTPATIENTS WITH ACUTE MAXILLARY SINUSITIS

The primary objective of this open, randomised study was to compare th e efficacy and tolerability of clarithromycin (500mg twice daily) and cefaclor (500mg 3 times daily) administered for 10 days in the treatme nt of acute nonodontogenic maxillary sinusitis in adults. Tolerability and efficacy were assessed during therapy (by phone), post-treatment, and at follow-up (30 to 45 days after completion of therapy). Additio nally, pretreatment sinus aspirates were cultured to determine which p athogens commonly cause sinusitis in southern Greece. Pathogens most c ommonly isolated were Streptococcus pneumoniae, 49%; Haemophilus speci es, 14%; Staphylococcus aureus, 10%; S. pyogenes, 10%; and Moraxella ( Branhamella) catarrhalis, 10%. Of the 93 outpatients enrolled, 48 rece ived clarithromycin and 45 received cefaclor, and both agents demonstr ated equivalent clinical efficacy, with post-treatment clinical succes s rates (cure or improvement) of 92.5 and 91.4%, respectively. Both dr ugs were associated with equivalent recurrence rates at follow-up (15 and 13%, respectively) and tolerability parameters were also comparabl e, although clarithromycin was associated with a significantly higher incidence of taste perversion than cefaclor (11 vs 2%, p < 0.05) and c efaclor was associated with a higher incidence of skin rash than clari thromycin (7 vs 0%, p < 0.05). Clarithromycin and cefaclor are both we ll tolerated and effective in the treatment of acute maxillary sinusit is in adults.