ROXITHROMYCIN 150 MG BID VERSUS AMOXICILLIN 500 MG CLAVULANIC ACID 125 MG TID FOR THE TREATMENT OF LOWER RESPIRATORY-TRACT INFECTIONS IN GENERAL-PRACTICE

Two hundred and forty-two patients over 16 years of age with community -acquired lower respiratory tract infection (LRTI), matched for age an d sex, were randomised to receive either roxithromycin 150 mg b.i.d, o r amoxycillin 500 mg/clavulanic acid 125 mg t.i.d. for 7 days, with a further 7 days if insufficient response was seen. Clinical efficacy at 7 days was 69% for roxithromycin and 56% for amoxycillin/clavulanic a cid (p=0.05) and at study end it was 91% for both antibiotics. There w ere fewer second treatment courses in the roxithromycin group (26% vs. 38%, p = 0.04) and a shorter treatment duration (8.29 days vs. 9.34 d ays, p > 0.05). Twelve patients (9.8%) treated with roxithromycin and 19 (17.1%) treated with amoxycillin/clavulanic acid had adverse effect s possibly or probably related to the antibiotic. Roxithromycin appear s to be a more appropriate choice than amoxycillin/clavulanic acid for the treatment of LRTI in the community given ifs more appropriate in vitro spectrum, efficacy against most: common and atypical pathogens, greater cost-effectiveness, more convenient dosage regimen (b. i. d.), and superior tolerability profile.