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阿莫西林/克拉维酸对成人细菌性鼻窦炎的疗效/安全性

Efficacy/safety of amoxicillin/clavulanate in adults with bacterial rhinosinusitis.

作者信息

Anon Jack B, Berkowitz Elchonon, Breton John, Twynholm Monique

机构信息

Department of Otolaryngology, University of Pittsburgh College of Medicine, Erie, PA 16508, USA.

出版信息

Am J Otolaryngol. 2006 Jul-Aug;27(4):248-54. doi: 10.1016/j.amjoto.2005.11.015.

DOI:10.1016/j.amjoto.2005.11.015
PMID:16798401
Abstract

PURPOSE

Acute bacterial rhinosinusitis (ABRS) is a common and uncomfortable condition, frequently caused by Streptococcus pneumoniae or Haemophilus influenzae. Antibacterial resistance among these and other common respiratory pathogens is now widespread and of concern. Pharmacokinetically enhanced amoxicillin/clavulanate 2000/125 mg was developed to be effective against the common respiratory pathogens, including many resistant strains.

MATERIALS AND METHODS

This open-label, noncomparative study assessed the bacteriologic and clinical efficacy of amoxicillin/clavulanate 2000/125 mg in adult patients with ABRS. Requirements for study entry included a clinical diagnosis of ABRS supported by radiologic findings. In addition, sinus puncture for bacteriologic assessment was required at study entry.

RESULTS

Overall, bacteriologic success (eradication or clinical evidence of eradication) at the follow-up visit (days 17-28) was achieved in 87.8% (722/822) of patients with 1 or more pathogen isolated at screening, in 93.2% (246/264) of patients with S pneumoniae, in 96.7% (29/30) of those with penicillin-resistant S pneumoniae (penicillin minimum inhibitory concentrations >or=2 microg/mL), and in 88.7% (110/124) of patients with beta-lactamase-positive pathogens. Bacteriologic success was achieved against 6 of 7 S pneumoniae isolates with amoxicillin/clavulanic acid minimum inhibitory concentrations of 4/2 microg/mL or higher.

CONCLUSIONS

Amoxicillin/clavulanate 2000/125 mg was generally well tolerated. This new amoxicillin/clavulanate formulation provides a suitable option for empiric therapy for ABRS in adults.

摘要

目的

急性细菌性鼻窦炎(ABRS)是一种常见且令人不适的病症,通常由肺炎链球菌或流感嗜血杆菌引起。这些以及其他常见呼吸道病原体的抗菌耐药性如今广泛存在且令人担忧。研发了药代动力学增强型阿莫西林/克拉维酸2000/125毫克,以有效对抗包括许多耐药菌株在内的常见呼吸道病原体。

材料与方法

这项开放标签、非对照研究评估了阿莫西林/克拉维酸2000/125毫克在成年ABRS患者中的细菌学和临床疗效。研究入组要求包括经影像学检查支持的ABRS临床诊断。此外,入组时需要进行鼻窦穿刺以进行细菌学评估。

结果

总体而言,在筛查时分离出1种或更多病原体的患者中,87.8%(722/822)在随访(第17 - 28天)时实现了细菌学成功(根除或根除的临床证据);肺炎链球菌患者中这一比例为93.2%(246/264);青霉素耐药肺炎链球菌(青霉素最低抑菌浓度≥2微克/毫升)患者中为96.7%(29/30);β-内酰胺酶阳性病原体患者中为88.7%(110/124)。对于7株肺炎链球菌分离株中阿莫西林/克拉维酸最低抑菌浓度为4/2微克/毫升或更高的6株,实现了细菌学成功。

结论

阿莫西林/克拉维酸2000/125毫克一般耐受性良好。这种新的阿莫西林/克拉维酸制剂为成人ABRS的经验性治疗提供了一种合适的选择。

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