Short Therapy with Amoxicillin-clavulanate and Corticosteroids in Acute Sinusitis: Results of a Multicentre Study in Adults

• Published in: Scandinavian journal of infectious diseases Vol. 32; no. 6; pp. 679 - 684
• Main Author: Pierre Gehanno, Claude Beauvillain, Serge Bobin, Jean-Claude Chobaut, Alain Desaulty, Christian Dubreuil, Jean-Michel Klossek, Jean-Jacques Pessey, Dominique Peyramond, Alain Strunski, Claude Chastang
• Format: Journal Article
• Language: English
• Published: Basingstoke Informa UK Ltd 2000; Taylor & Francis
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; amoxicillin-clavulanate; Amoxicillin-Potassium Clavulanate Combination - administration & dosage; Amoxicillin-Potassium Clavulanate Combination - therapeutic use; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Double-Blind Method; Drug Therapy, Combination - administration & dosage; Drug Therapy, Combination - therapeutic use; Female; Humans; Male; Medical sciences; Methylprednisolone - administration & dosage; Methylprednisolone - therapeutic use; Middle Aged; Pharmacology. Drug treatments; Risk Factors; Sinusitis - drug therapy; Sinusitis - microbiology; Time Factors; Treatment Outcome; Human; Corticosteroid; Drug combination; Relapse; Clavulanic acid; Acute; Treatment efficiency; β-Lactams; Antiinflammatory agent; Sinusitis; Penicillin derivatives; Resistance; Antibiotic; Chemotherapy; Treatment; Amoxicillin; Risk factor; ENT disease; Adult; Evolution; Paranasal sinus disease; Antibacterial agent
• ISSN: 0036-5548; 1651-1980
• DOI: 10.1080/003655400459621

Evolution of bacterial resistance shortens antibiotic treatment in ENT infections. The efficacy and tolerance of amoxicillinclavulanate (ACA), with and without associated short steroid therapy, was evaluated in acute sinusitis of adults at a dosage of 1.5 g/d for 5 d vs. 10 d. This multicentre, randomized, double-blind, placebo-controlled study included 433 patients, 417 of whom were suitable for intent-to-treat (ITT) analysis. The therapeutic success rate in the ITT population, assessed according to strict clinical and radiological criteria, was, respectively, 80% and 85% in the 5-d and 10-d treatment groups. Due to the statistical risks that were evidenced, the 2 durations of treatment could not be considered equivalent. The analysis of medical history shows that some risk factors (recurrence of sinusitis, previous surgical sinus drainage) seem to promote therapeutic failure and that 5-d treatment is inappropriate in these patients. The persistence of therapeutic success on day 30 was not influenced by the initial duration of treatment. The efficacy and good tolerance of ACA in acute sinusitis in adults were confirmed. Further studies will be needed to define the indications of short treatments better, which seem to be indicated in the absence of specific risk factors.