Hayle R, Lingaas E, Høivik H O, Odegård T
Department of Otolaryngology, National Hospital, Oslo, Norway.
Eur J Clin Microbiol Infect Dis. 1996 Nov;15(11):849-53. doi: 10.1007/BF01691214.
In the treatment of acute maxillary sinusitis, azithromycin offers an advantage over phenoxymethylpenicillin in that a complete course of treatment requires drug administration once daily for only three days. In this double-blind, parallel-group, multicenter study, 438 patients with radiographically verified maxillary sinusitis were randomly assigned to receive either 500 mg azithromycin once daily for three days (221 patients) or 1.3 g phenoxymethylpenicillin three times daily for ten days (217 patients). Nasal secretion, maxillary tenderness and pain, nasal obstruction, general malaise, and hyposmia, were assessed at the start of the study and on days 4, 11, and 25 of treatment. After 11 days 58% of the patients in the azithromycin group were cured versus 51% in the penicillin group; after 25 days the cure rate was 79% versus 76%, respectively. When both cure and improvement were considered, the corresponding figures after 11 days were 97% (azithromycin) and 95% (penicillin); after 25 days they were 92% and 88%, respectively. Adverse events, predominantly gastrointestinal, occurred in 73 (33%) of the azithromycin-treated patients and in 87 (40.1%) of those treated with penicillin. No difference in efficacy was found between the two drugs in the treatment of acute maxillary sinusitis, and the adverse effects were comparable. The short duration of treatment with azithromycin offers a significant advantage over treatment with phenoxymethylpenicillin.
在急性上颌窦炎的治疗中，阿奇霉素比青霉素V钾具有优势，因为完整疗程仅需每日给药一次，持续三天。在这项双盲、平行组、多中心研究中，438例经影像学证实患有上颌窦炎的患者被随机分配，分别接受为期三天、每日一次500毫克阿奇霉素治疗（221例患者）或为期十天、每日三次1.3克青霉素V钾治疗（217例患者）。在研究开始时以及治疗的第4天、第11天和第25天，对鼻分泌物、上颌压痛和疼痛、鼻塞、全身不适和嗅觉减退进行评估。11天后，阿奇霉素组58%的患者治愈，而青霉素组为51%；25天后，治愈率分别为79%和76%。若同时考虑治愈和病情改善情况，11天后相应的数据分别为97%（阿奇霉素）和95%（青霉素）；25天后分别为92%和88%。在接受阿奇霉素治疗的患者中，73例（33%）出现不良事件，主要为胃肠道反应，而在接受青霉素治疗的患者中，这一比例为87例（40.1%）。两种药物在治疗急性上颌窦炎时疗效无差异，不良反应相当。阿奇霉素治疗疗程短，与青霉素V钾治疗相比具有显著优势。
