Huck W, Reed B D, Nielsen R W, Ferguson R T, Gray D W, Lund G K, ZoBell D H, Moster M B
Advanced Clinical Microbiology/Research, Salt Lake City, Utah.
Arch Fam Med. 1993 May;2(5):497-503. doi: 10.1001/archfami.2.5.497.
The treatment of acute, recurrent, and chronic sinusitis remains controversial because of the presence of a wide variety of aerobic and anaerobic bacteria in the sinuses.
This double-blind, randomized trial compared cefaclor with amoxicillin in the treatment of acute, recurrent, and chronic maxillary sinusitis using clinical evaluation, roentgenography, and microbiologic evaluation of antral aspirates.
Outpatient office of five otorhinolaryngologists in Salt Lake City, Utah.
One hundred eight adult patients with acute, recurrent, or chronic maxillary sinusitis.
Oral treatment with cefaclor (500 mg) twice daily or amoxicillin (500 mg) three times daily for 10 days.
Clinical response to treatment with cefaclor vs amoxicillin.
Fifty-six patients with acute sinusitis, 25 with recurrent sinusitis, and 15 with chronic sinusitis were evaluable. Although multiple organisms were common in each group, patients with acute sinusitis were more likely to have Haemophilus influenzae or Streptococcus pneumoniae, and patients with recurrent or chronic sinusitis were more likely to have anaerobes in sinus aspirate. Whether treated with cefaclor or amoxicillin, clinical improvement occurred in 86% of patients with acute sinusitis and 56% of patients with recurrent sinusitis. Patients with chronic sinusitis were too few to allow statistical analysis of the differences in outcome between them and patients with recurrent or acute sinusitis. Resistance of the cultured organisms to the study drug used was unrelated to treatment outcome.
The rate of clinical improvement was high in patients with acute sinusitis but was less favorable in those with recurrent and chronic disease regardless of the study drug used. The susceptibility of organisms isolated to the study drugs was unrelated to outcome.
由于鼻窦中存在多种需氧菌和厌氧菌，急性、复发性和慢性鼻窦炎的治疗仍存在争议。
这项双盲随机试验使用临床评估、X线摄影和上颌窦穿刺液的微生物学评估，比较了头孢克洛和阿莫西林治疗急性、复发性和慢性上颌窦炎的效果。
犹他州盐湖城五位耳鼻喉科医生的门诊办公室。
108例患有急性、复发性或慢性上颌窦炎的成年患者。
口服头孢克洛（500毫克），每日两次，或阿莫西林（500毫克），每日三次，持续10天。
头孢克洛与阿莫西林治疗的临床反应。
56例急性鼻窦炎患者、25例复发性鼻窦炎患者和15例慢性鼻窦炎患者可进行评估。虽然每组中多种微生物都很常见，但急性鼻窦炎患者更易感染流感嗜血杆菌或肺炎链球菌，而复发性或慢性鼻窦炎患者的鼻窦穿刺液中更易发现厌氧菌。无论接受头孢克洛还是阿莫西林治疗，86%的急性鼻窦炎患者和56%的复发性鼻窦炎患者临床症状得到改善。慢性鼻窦炎患者数量过少，无法对其与复发性或急性鼻窦炎患者的治疗结果差异进行统计学分析。培养出的微生物对所用研究药物的耐药性与治疗结果无关。
无论使用哪种研究药物，急性鼻窦炎患者的临床改善率都很高，但复发性和慢性疾病患者的改善情况较差。分离出的微生物对研究药物的敏感性与治疗结果无关。
