Treatment of sinusitis and otitis media with pivampicillin.

The efficacy and tolerance of two different dosage regimens of pivampicillin was compared in 155 patients with acute sinusitis and in 56 patients with otitis media. Patients received a 10-day course of either 500 mg pivampicillin twice daily, or 350 mg pivampicillin 3-times a day. Out of the 155 patients with sinusitis, 68 patients received pivampicillin at the time of diagnosis, whilst in a further 87 patients treatment was given, on average, 7 days after the diagnosis was made. Approximately 78% of the patients had Proetz suction and 17% used nasal drops or spray. Among 77 patients given the 500 mg dose, 88% were cured, 8% improved and only 4% failed to respond. Ninety-one per cent of 70 evaluated patients receiving the 350 mg dose were cured and 9% were improved. Paracentesis was performed on 43 of the 56 patients with otitis media and spontaneous perforation occurred in 7 patients. Eight patients received supplementary treatment with ear drops. Ninety-one per cent of 32 evaluated patients on the 500 mg dose were cured and 9% improved. The corresponding response rate in 20 evaluated patients given the 350 mg tablets was 80% cured, 15% improved and 5% of patients failed to respond. There was no difference in the frequency of side-effects between the two regimens. Approximately 4% of the patients had gastro-intestinal side-effects or skin rashes and in only 6 patients did these necessitate withdrawal of therapy. The twice daily regimen is recommended because of increased patient compliance.