TREATMENT OF COMMUNITY ACQUIRED ACUTE SINUSITIS - CEFUROXIME AXETIL VS CEFIXIME

Between january and may 1990, 137 patients (64 males and 73 females; mean age 40 +/- 16 years (+/- standard deviation) with acute sinusitis were randomized to receive either cefuroxime axetil (69 patients, 250 mg bid) or cefixime (68 patients, 200 mg bid) for 8 days. The diagnosis of acute sinusitis (facial pain, purulent rhinitis) was confirmed by radiologic findings. The patients were recruited by 26 ENT specialists in the community. Bacterial cultures of sinus secretions were performed allowing to isolate 161 microorganisms in 106 patients (77 %). Haemophilus influenzae, Streptococcus spp, Branhamella catarrhalis and Staphylococcus spp represented 84.5 % of isolates. In vitro, 93 % of the organisms were susceptible to cefuroxime as compared to 69 % for cefixime. The number of patients with at least one resistant strain to the allocated regimen was 7 for cefuroxime axetil (10 %) and 22 for cefixime (32.4 %) (p < 0.01). The rate of clinical success was 86 % for cefuroxime axetil and 84 % for cefixime. With regards to the in vitro activity of the antibiotics on strains isolated in acute community-acquired sinusitis, cefuroxime axetil appears more suitable than cefixime. On this population, this advantage was not confirmed by clinical efficacy.