Multicenter evaluation of azithromycin and cefaclor in acute lower respiratory tract infections

Article Abstract:

The effectiveness of a newly developed antibiotic, azithromycin, was evaluated for treating lower respiratory tract infections (LRTIs), such as bronchitis and pneumonia, in 272 patients at 26 medical centers. This drug is a member of the azalide group of antibiotics, and offers several advantages over erythromycin (used for treating some lung infections), including fewer side effects, greater stability in the stomach, a longer half-life, and high concentrations in body tissues, particularly the lung. Patients in the study were evaluated using clinical, laboratory, and radiographic tests, and by bacteriologic analysis of sputum. They were randomly assigned to receive either azithromycin (191 patients) or cefaclor, a cephalosporin active against many typical respiratory tract pathogens, (81 patients), and were evaluated on days 6, 11, 18, and 30. The proportion of patients cured or improved was high in both groups: 96.3 percent in the azithromycin group and 95.1 percent in the cefaclor group. The cure rate according to bacteriologic results (eradication of the causative organism) was 88.2 percent for azithromycin patients and 87.9 percent for cefaclor patients. Azithromycin was more effective (94.5 percent) than cefaclor (61.1 percent) against Haemophilus influenzae. A similar proportion of patients in the two groups reported side effects from their therapy, but most side effects were mild. The results indicate that a five-day course of once-daily azithromycin is as effective as a 10-day course of three times-daily cefaclor for treating LRTIs, a common, but potentially life-threatening condition. (Consumer Summary produced by Reliance Medical Information, Inc.)

Respiratory tract infections, Cefaclor

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Azithromycin and amoxicillin in the treatment of acute maxillary sinusitis

Article Abstract:

A study was carried out at 13 medical centers to compare the effectiveness of azithromycin, a new azalide antibiotic, with that of amoxicillin for treating acute maxillary sinusitis (inflammation of the sinuses between the eyes and upper jaw). Seventy-eight patients were randomly assigned to receive either azithromycin (41 subjects) or amoxicillin (37 subjects): of these, 38 completed the study and were considered evaluable. The diagnosis of acute sinusitis was made when bacteria were identified in sinus fluid. After treatment started, patients were examined on days 6, 11, 18, and 30. Results showed a bacteriologic cure rate of 100 percent in both groups. Both treatment groups indicated only mild side effects, which were reported by 4.9 percent of the azithromycin patients and 8.1 percent of the amoxicillin patients. Azithromycin was given five times over a 5-day period, whereas 30 doses of amoxicillin were given over 10 days. The fact that the former drug was effective with fewer doses should improve patient compliance. Azithromycin seems to be a well-tolerated, effective drug for treating acute sinusitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sinusitis, Amoxicillin

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