Azithromycin versus amoxicillin/clavulanate in the treatment of acute sinusitis

Purpose: To compare the efficacy and tolerability of a 3-day course of azit hromycin with a 10-day course of amoxicillin/clavulanic acid in the treatme nt of acute sinusitis in adults. Patients and Methods: One hundred adult patients with acute sinusitis were included in an open, randomized study. Clinical diagnosis of sinusitis was confirmed by nasal endoscopy, sinus radiography, and (when possible) by cul ture of sinus aspirate. Patients were randomized to receive azithromycin (5 00 mg once daily for 3 days) or amoxicillin/clavulanate (625 mg every 8 hou rs for 10 days). Results: A significantly faster resolution of signs and symptoms of sinusit is was observed in the azithromycin-treated patients. By the end of therapy (days 10-12), 95% of the patients in the azithromycin group and 74% in the amoxicillin/clavulanate group were cured. The remaining patients' conditio ns were improved. By the follow-up visit, cure was achieved in 98% of the a zithromycin-treated patients, and 91% of the amoxicillin/clavulanate-treate d patients. Treatment failure was observed in three patients from the amoxi cillin/clavulanate group, and relapse occurred in one patient from each gro up. Bacteriologic eradication was achieved in 23 of 23 and 21 of 24 patient s treated with azithromycin and amoxicillin/clavulanate, respectively. Both drugs were well tolerated. Two patients (4%) from the azithromycin group a nd five patients (10%) from the amoxicillin/clavulanate group reported mild gastrointestinal disturbances. Conclusions: In adults with acute sinusitis, a 3-day course of azithromycin was as effective and well tolerated as a 10-day course of amoxicillin/clav ulanic acid. A significantly simpler dosage regimen and faster clinical eff ect were the advantages of azithromycin. Copyright (C) 1999 by W.B. Saunder s Company.