Comparison of roxithromycin with co-amoxiclav in patients with sinusitis

Abstract

In an open, randomized study of 60 patients with acute or recurrent sinusitis, the bacteriological and clinical efficacy of roxithromycin 150 mg bd were compared with those of po co-amoxiclav (625 mg) tds. Of 52 patients who underwent sinus puncture for isolation of causative organisms, 48 had pathogens sensitive to both antibiotics. Satisfactory clinical response was obtained in 93.1% (27/29) evaluable patients receiving roxithromycin and 88.8% (24/27) receiving co-amoxiclav. Tolerability was significantly better in the roxithromycin group, with 1/29 (3.4%) patients in this group experiencing gastrointestinal side-effects, compared with 7/27 (25.9%) patients in the co-amoxiclav group (P < 0.05). Although the study had limited power to detect differences, roxithromycin demonstrated clinical, bacteriological and overall efficacy similar to that of co-amoxiclav, but with better tolerability. Roxithromycin thus appears to be an effective and well-tolerated drug for the treatment of acute and recurrent sinusitis.

Staphylococcus aureus Is a Major Pathogen in Acute Bacterial Rhinosinusitis: A Meta-Analysis

“…In addition, most of the studies required a combination of these radiographic findings and 1 or 2 major signs or symptoms of ABRS, including facial pain or tenderness, nasal congestion, or purulent discharge. Four articles listed only "clinical diagnosis of ABRS" as an enrollment criterium [9,10,17,19]. A weighted mean value analysis for the 25 articles was performed to determine the culture rates for the 4 major pathogens.…”

“…Of the remaining 9 articles, 1 specifically mentioned that prior antibiotic therapy did not exclude enrollment [17], and 8 did not specifically mention this factor [9,12,14,16,[19][20][21]27]. The weighted rates for the articles that specifically excluded patients who had received prior antibiotic therapy were also calculated and found to not be significantly different from rates calculated including all articles.…”

Lack of in vitro and in vivo Selection of Bacterial Resistance by Roxithromycin

“…10 5 CFU/ml. Results were observed after 18 h of incubation at 37°C in 5% CO 2 Drago/Fassina/De Vecchi/Mombelli/ Lombardi/Gismondo atmosphere and the MIC was defined as the lowest concentration able to inhibit visible growth. The MBC was determined by plating a known quantity of inoculum from the wells showing no visible growth on solid agar plates and reading them after incubation for 18-24 h. The MBC was defined as the concentration at which there was a 99.9% reduction in CFU when compared with the original inoculum.…”

“…Among these new compounds, roxithromycin (ROX) showed clinical and bacteriological efficacy similar to that of other antimicrobials, and better tolerability [2][3][4]. These characteristics, together with the advantage of a once-daily dose, make ROX an attractive therapeutic option in the treatment of respiratory infections [5].…”

The use of roxithromycin in the treatment of acute bacterial rhinosinusitis

“…Нежелательные явления в группе амоксициллина/клавуланата зарегистрированы у 25,9% пациентов (р < 0,05). Таким образом, рокситромицин продемонстрировал клиническую и бактериологическую эффективность, аналогичную амоксициллину/клавуланату, но с лучшей переносимостью для лечения острого и рецидивирующего синусита [19]. В исследовании Mira и Benazzo (2001) были получены схожие результаты (эффективность лечения рокситромицином составила 82%, амоксициллином/клавуланатом -78%), но при этом преимуществом назначения рокситромицина в данном случае являлась возможность однократного приема, а также меньшие затраты на лечение [20].…”