Dual action of gemifloxacin in acute bacterial sinusitis in patients with allergic rhinitis: antibacterial and immunomodulatory effects?
Abstract number: p1576
Lode H., Garau J., File T., Ball P., Tillotson G., Morrissey I.
Acute bacterial sinusitis (ABS) is a common infection world-wide, with many patients having an associated an allergic component/history. However the role of antibacterials in these patients (pts) has not been examined. As some fluoroquinolones (FQ) have an in-vitro immunomodulatory effect (IE) the clinical efficacy of GEM was compared other agents in ABS pts with or without allergic rhinitis (AR).
5 phase 3 clinical trials were pooled and pts where allergic rhinitis was identified (584 pts) were compared with pts not reporting AR (1834 pts). Clinical response (success or failure) at end of therapy (EOT) & at follow-up (FU, approx. 13 weeks after treatment) was studied. Comparators (CMP) were cefuroxime (CEF) and trovafloxacin (TRO).
% Success based on clinical outcome at EOT and FU for AR and non AR pts are shown in the table. For all treatments EOT success was high for the non AR pts, but at FU this was reduced, especially with both FQs. In contrast, GEM retained a high clinical success rate in pts with AR unlike CEF or TRO.
GEM has been shown to be very efficacious in a sub group of problematic ABS pts. This advantage may be due to the high antibacterial activity of GEM vs key ABS pathogens and/or a stimulatory IE. Both being important with pts having decreased local immune defences. These data also show that not all fluoroquinolones have immuno-stimulatory properties.
|Session name:||XXIst ISTH Congress|
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