Klapan I, Culig J, Oresković K, Matrapazovski M, Radosević S
Ear, Nose, and Throat Department, Zagreb University School of Medicine, Croatia.
Am J Otolaryngol. 1999 Jan-Feb;20(1):7-11. doi: 10.1016/s0196-0709(99)90044-3.
To compare the efficacy and tolerability of a 3-day course of azithromycin with a 10-day course of amoxicillin/clavulanic acid in the treatment of acute sinusitis in adults.
One hundred adult patients with acute sinusitis were included in an open, randomized study. Clinical diagnosis of sinusitis was confirmed by nasal endoscopy, sinus radiography, and (when possible) by culture of sinus aspirate. Patients were randomized to receive azithromycin (500 mg once daily for 3 days) or amoxicillin/clavulanate (625 mg every 8 hours for 10 days).
A significantly faster resolution of signs and symptoms of sinusitis was observed in the azithromycin-treated patients. By the end of therapy (days 10-12), 95% of the patients in the azithromycin group and 74% in the amoxicillin/clavulanate group were cured. The remaining patients' conditions were improved. By the follow-up visit, cure was achieved in 98% of the azithromycin-treated patients, and 91% of the amoxicillin/clavulanate-treated patients. Treatment failure was observed in three patients from the amoxicillin/clavulanate group, and relapse occurred in one patient from each group. Bacteriologic eradication was achieved in 23 of 23 and 21 of 24 patients treated with azithromycin and amoxicillin/clavulanate, respectively. Both drugs were well tolerated. Two patients (4%) from the azithromycin group and five patients (10%) from the amoxicillin/clavulanate group reported mild gastrointestinal disturbances.
In adults with acute sinusitis, a 3-day course of azithromycin was as effective and well tolerated as a 10-day course of amoxicillin/clavulanic acid. A significantly simpler dosage regimen and faster clinical effect were the advantages of azithromycin.
比较阿奇霉素3日疗程与阿莫西林/克拉维酸10日疗程治疗成人急性鼻窦炎的疗效和耐受性。
100例成人急性鼻窦炎患者纳入一项开放、随机研究。鼻窦炎的临床诊断通过鼻内镜检查、鼻窦X线摄影以及（可能时）鼻窦抽吸物培养来确诊。患者随机接受阿奇霉素（500mg，每日1次，共3天）或阿莫西林/克拉维酸（625mg，每8小时1次，共10天）治疗。
阿奇霉素治疗的患者中，鼻窦炎的体征和症状缓解明显更快。治疗结束时（第10 - 12天），阿奇霉素组95%的患者和阿莫西林/克拉维酸组74%的患者治愈。其余患者病情改善。随访时，阿奇霉素治疗的患者中98%治愈，阿莫西林/克拉维酸治疗的患者中91%治愈。阿莫西林/克拉维酸组有3例患者治疗失败，两组各有1例患者复发。阿奇霉素治疗的23例患者和阿莫西林/克拉维酸治疗的24例患者中分别有23例和21例实现细菌清除。两种药物耐受性均良好。阿奇霉素组2例患者（4%）和阿莫西林/克拉维酸组5例患者（10%）报告有轻度胃肠道不适。
在成人急性鼻窦炎患者中，阿奇霉素3日疗程与阿莫西林/克拉维酸10日疗程疗效相当且耐受性良好。阿奇霉素的优势在于给药方案明显更简单且临床效果更快。
