Azithromycin is not less effective than amoxicillin clavulanate in the treatment of acute bacterial sinusitis

Azithromycin is used to treat infections of the upper respiratory tract caused by sensitive microorganisms. The recommended dose is 500 mg daily for 3 days. Amoxicillin / clavulanate is a combination of a β-lactam antibiotic, amoxicillin, and a β-lactamase inhibitor, clavulanate.

A group of American researchers compared the efficacy and safety of two treatment regimens with azithromycin - 500 mg once daily for 3 days (AZM-3) and for 6 days (AZM-6) and amoxicillin / clavulanate 500/125 mg 3 times a day. within 10 days (A / K-10).

The study involved 936 patients with a clinically and radiologically confirmed diagnosis of acute bacterial sinusitis, 312 patients received treatment according to the AZM-3 scheme, 311 - AZM-6 and 313 - A / K-10. The clinical efficacy at the end of treatment (day 10) was almost the same and was 88.8% for AZM-3, 89.3% for AZM-6 and 84.9% for A / K-10; at the end of the study (day 28): 71.7% for AZM-3, 73.4% for AZM-6 and 71.3 % for A / K-10.

Patients receiving A / K-10 therapy showed a higher incidence of adverse drug reactions - 51.1% compared to azithromycin: AZM-3 - 31 , 1% (p less than 0.001) and AZM-6 37.6% (p less than 0.001). The most common side effect was diarrhea. More patients who received A / K-10 treatment were excluded from the study (n = 28) compared to AZM-3 (n = 7) and AZM-6 (n = 11).

The study showed that in the treatment of acute bacterial sinusitis, the two regimens of azithromycin are also effective compared to the standard 10-day treatment with amoxicillin / clavulanate, and the incidence of adverse drug reactions with azithromycin was lower and compliance was higher.

However, more studies are needed to determine the bacteriological efficacy of azithromycin in acute sinusitis.