A comparison study of amoxicillin-clavulanate and azithromycin efficacy in treatment of acute sinusitis

Abstract number: p703

Zangeneh  M., Shariati  N., Yazdanyar  A., Jamshidi Makiani  M., Haghighi  S.

Background: 

Acute bacterial sinusitis is an acute infection of the paranasal sinuses. Approximately 30 million Americans develop acute bacterial sinusitis annually, resulting in an estimated 25 million physician visits. Shorter courses of antimicrobial therapy (3 to 5 days) tend to increase patients compliance, decrease adverse events, decrease the emergence of resistant strains, and reduce cost. We compared the efficacy and safety of azithromycin regimens, 250 mg/day once daily for 5 days to the efficacy and safety of amoxicillin-clavulanate regimen of 500 mg 3 times daily for 10 days.

Methods: 

A total number of 80 subjects with clinically and radiologically documented acute bacterial sinusitis were treated with (azithromycin 40 subjects, amxicillin-clavulanate 50 subjects).

Results: 

Mean age 32.7 years, male 60%, female 40%, the most common symptoms were headache and paranasal discharge, maxillary sinus was more infected 49%. Clinical success rates were among subjects at the end of therapy (azithromycin 53%, amoxicillin-clavulanate 90%). Subjects treated with amoxicillin-clavulanate reported a higher incidence of treatment-related adverse events (15%) than azithromycin (7%, p > 0.005). Gastrointestinal discomfort was the most frequent treatment related adverse effect.

Conclusion: 

For subjects with clinically and radiologically documented acute bacterial sinusitis azithromycin given in a 250 mg dose once daily for 5 days was not shown to be as efficacious as amoxicillin-clavulanate 500 mg 3 times/day for 10 days.