Treatment of acute maxillary sinusitis in adult outpatients: comparison of a five versus ten day-course of cefuroxime axetil

Dubreuil, C.; Géhanno, P; Goldstein, F. W.; Pancrazi, Jean Noël; Timsit, C; Leblanc, F.; Meunier, Anne; Chauveau, Éric

doi:10.1016/s0399-077x(01)00171-8

Cited by 4 publications

(12 citation statements)

References 18 publications

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“…We identified 283 and 313 potentially relevant RCTs, respectively. We finally selected 12 RCTs [17–28] that fulfilled the criteria for inclusion in this meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the methodological design of the 12 included RCTs, 10 were double‐blinded [17–22, 24, 26–28]. Moreover, all but two of the included RCTs were assigned a Jadad score of at least 4 [17–20, 23–28]. Regarding study population, all of the included RCTs involved adult patients with uncomplicated ABS. Seven of the overall 12 RCTs referred particularly to patients with maxillary sinusitis [19, 20, 23–27]. The diagnosis of ABS was radiologically confirmed in all of the included RCTs. Furthermore, the required duration of symptoms of ABS prior to inclusion was >7–10 days in five RCTs [17, 20, 23, 24, 26].…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, the required duration of symptoms of ABS prior to inclusion was >7–10 days in five RCTs [17, 20, 23, 24, 26]. Nine RCTs allowed the use of specific concomitant symptom relief medications [18, 19, 21, 23–28], which in two cases included the use of oral corticosteroids [18, 28].…”

Section: Resultsmentioning

confidence: 99%

“…Patients in the short‐course treatment arms received therapy for 5 days in eight of the included RCTs [17–19, 21–23, 26, 27], for 3 days in two RCTs [20, 25], for 4 days in one RCT [28] and for 7 days in the remaining one RCT [24]. Patients in the long‐course treatment arms received therapy for 10 days in 10 of the included RCTs [18, 19, 21–28] and for 6 days [20] and 7 days [17] in one RCT, respectively. In seven out of 12 RCTs [18, 19, 21–23, 26, 27] the duration of administered regimens was 5 and 10 days for the short‐course and the long‐course regimens, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Patients in the long‐course treatment arms received therapy for 10 days in 10 of the included RCTs [18, 19, 21–28] and for 6 days [20] and 7 days [17] in one RCT, respectively. In seven out of 12 RCTs [18, 19, 21–23, 26, 27] the duration of administered regimens was 5 and 10 days for the short‐course and the long‐course regimens, respectively. The antibiotics used were β‐lactams in six out of 12 RCTs [18, 19, 24, 26–28], along with fluoroquinolones [17, 23], telithromycin [21, 22], azithromycin [20] and trimethoprim/sulfamethoxazole [25] in two, two, one and one RCTs, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta‐analysis of randomized trials

Falagas

Karageorgopoulos

Grammatikos

et al. 2009

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Treatment guidelines generally support that a 10–14‐day antibiotic regimen should be administered to uncomplicated acute bacterial sinusitis patients. • However, the level of evidence for such a recommendation is rather weak. • Treatment of such duration may have disadvantages compared with a shorter duration but equally effective regimen, including the promotion of bacterial drug resistance, poorest patient compliance, higher toxicity, and a greater overall economic burden. WHAT THIS STUDY ADDS • The findings of this meta‐analysis suggest that short‐course antibiotic treatment has similar effectiveness to longer‐course treatment for patients with acute uncomplicated bacterial sinusitis, when treatment is warranted. • However, we should underscore the importance of the clinician's own assessment, so that antimicrobial therapy should not inappropriately be curtailed in a patient not adequately responding to the regimen administered. We sought to evaluate the effectiveness and safety of short‐course antibiotic treatment for acute bacterial sinusitis (ABS) compared with longer duration treatment. We performed a meta‐analysis of randomized controlled trials (RCTs), identified by searching PubMed and the Cochrane Central Register of Controlled Trials. We included RCTs that compared short‐course (up to 7 days) vs. long‐course therapy (≥2 days longer than short‐course), with the same antimicrobial agent, in the same daily dosage, for patients with ABS. Twelve RCTs (10 double‐blinded) involving adult patients with radiologically confirmed ABS were included. There was no difference in the comparison of short‐course (3–7 days) with long‐course treatment (6–10 days) regarding clinical success [12 RCTs, 4430 patients, fixed effect model (FEM), odds ratio (OR) 0.95, 95% confidence interval (CI) 0.81, 1.12]; microbiological efficacy; relapses; adverse events (10 RCTs, 4172 patients, random effects model, OR 0.88, 95% CI 0.71, 1.09); or withdrawals due to adverse events. In the sensitivity analysis comparing 5‐ vs. 10‐day regimens, clinical success was similar, although adverse events were fewer with short‐course treatment (5 RCTs, 2151 patients, FEM, OR 0.79, 95% CI 0.63, 0.98). Although antibiotics for acute sinusitis should be reserved for select patients with substantial probability of bacterial disease, accurate clinical diagnosis is often difficult to attain. Short‐course antibiotic treatment had comparable effectiveness to a longer course of therapy for ABS. Shortened treatment, particularly for patients without severe disease and complicating factors, might lead to fewer adverse events, better patient compliance, lower rates of resistance development and fewer costs.

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“…We identified 283 and 313 potentially relevant RCTs, respectively. We finally selected 12 RCTs [17–28] that fulfilled the criteria for inclusion in this meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta‐analysis of randomized trials

Falagas

Karageorgopoulos

Grammatikos

et al. 2009

Brit J Clinical Pharma

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Estimating daily antibiotic harms: an umbrella review with individual study meta-analysis

Curran

Leung

et al. 2022

Clinical Microbiology and Infection

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Cefuroxime Axetil

Scott¹,

Ormrod²,

Goa³

2001

Drugs

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Cefuroxime axetil is a broad spectrum antibacterial agent with a pharmacokinetic profile that permits convenient twice-daily administration. The drug is an effective and well tolerated treatment in patients with various infections, including otitis media, pharyngitis, sinusitis, CAP and acute exacerbations of chronic bronchitis. Cefuroxime axetil proved effective as a component of intravenous/oral sequential therapy in the treatment of CAP, although there are currently no dosage recommendations available for this regimen in some countries. Cefuroxime axetil may be considered as an empirical therapy for a range of community-acquired infections, including those in which beta-lactamase-producing strains of common respiratory pathogens are identified as the causative organisms. In an era of rapidly emerging bacterial resistance, empirical treatment with bacterial agents, potentially preventing the emergence of bacterial resistance to agents such as cefuroxime axetil may ensure the appropriate use of newer antibacterial agents, potentially preventing the emergence of bacterial resistance to these newer drugs.

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Treatment of acute maxillary sinusitis in adult outpatients: comparison of a five versus ten day-course of cefuroxime axetil

Cited by 4 publications

References 18 publications

Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta‐analysis of randomized trials

Effectiveness and safety of short vs. long duration of antibiotic therapy for acute bacterial sinusitis: a meta‐analysis of randomized trials

Estimating daily antibiotic harms: an umbrella review with individual study meta-analysis

Cefuroxime Axetil

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