COMPARISON OF ORAL CEFUROXIME AXETIL AND ORAL AMOXYCILLIN CLAVULANATEIN THE TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA/

Cefuroxime axetil has been evaluated previously in the treatment of lo wer respiratory tract infections, but not specifically in the treatmen t of community-acquired pneumonia. In a multicentre, investigator-blin ded clinical trial, 162 patients with community-acquired pneumonia wer e randomly assigned to receive orally either cefuroxime axetil 500 mg bid (n = 84) or amoxycillin/clavulanate 500 mg/125 mg tid (n = 78) for 10 days. Organisms were isolated from the pretreatment sputum specime ns of 97 of 162 (60%) patients, the commonest isolates being Streptoco ccus pneumoniae (38%) and Haemophilus influenzae (18%). A satisfactory clinical outcome (cure or improvement) was achieved in 100% (55 of 55 ) and 96% (49 of 51) of the clinically evaluable patients treated with cefuroxime axetil or amoxycillin/clavulanate, respectively (P = 0.23) . With respect to eradication of bacterial pathogens, a satisfactory o utcome (cure, presumed cure or cure with colonization) was obtained in 94% (32 of 34) and 93% (37 of 40) of bacteriologically evaluable pati ents treated with cefuroxime axetil or amoxycillin/clavulanate, respec tively (P = 1.00). Both treatment regimens used in this study were wel l tolerated. The most common drug-related adverse experiences were gas trointestinal events, reported by 8% and 4%, respectively, of the pati ents in the amoxycillin/clavulanate and cefuroxime axetil groups, a di fference which was not statistically significant (P = 0.32). These res ults indicate that cefuroxime axetil twice a day is as effective as am oxycillin/clavulanate three times a day in the treatment of outpatient s with mild to moderate community-acquired pneumonia.