Short therapy with amoxicillin-clavulanate and corticosteroids in acute sinusitis: Results of a multicentre study in adults

Evolution of bacterial resistance shortens antibiotic treatment in ENT infe ctions. The efficacy and tolerance of amoxicillin-clavulanate (ACA), with a nd without associated short steroid therapy, was evaluated in acute sinusit is of adults at a dosage of 1.5 g/d for 5 d vs, 10 d. This multicentre, ran domized, double-blind, placebo-controlled study included 433 patients, 417 of whom were suitable for intent-to-treat (ITT) analysis. The therapeutic s uccess rate in the ITT population, assessed according to strict clinical an d radiological criteria, was, respectively, 80% and 85% in the 5-d and 10-d treatment groups. Due to the statistical risks that were evidenced, the 2 durations of treatment could not be considered equivalent. The analysis of medical history shows that some risk factors (recurrence of sinusitis, prev ious surgical sinus drainage) seem to promote therapeutic failure and that 5-d treatment is inappropriate in these patients. The persistence of therap eutic success on day 30 was not influenced by the initial duration of treat ment. The efficacy and good tolerance of ACA in acute sinusitis in adults w ere confirmed. Further studies will be needed to define the indications of short treatments better, which seem to be indicated in the absence of speci fic risk factors.