Treatment of acute maxillary sinusitis in childhood: a comparative study of amoxicillin and cefaclor.
Maxillary sinus aspiration and quantitative culture of the aspirate were performed in 50 patients, ranging in age from 1 to 16 years, with clinical and radiographic evidence of acute sinusitis. Of 79 sinuses aspirated, at least one was found to be infected in 35 (70%) children. Streptococcus pneumoniae, Branhamella catarrhalis, and Haemophilus influenzae were the most common organisms recovered. All H. influenzae were nontypeable. Twenty percent of the H. influenzae and 27% of the B. catarrhalis organisms were beta-lactamase positive and amoxicillin resistant. The subjects received either amoxicillin or cefaclor at a dose of 40 mg/kg/day in three doses for 10 days. The clinical cure rate with amoxicillin was 81%, compared to 78% with cefaclor. Radiographic improvement was similar in both treatment groups. Antibiotic therapy failed in four patients; three had been given amoxicillin, and one cefaclor. In three of these, a beta-lactamase-positive antibiotic-resistant bacterial species was recovered from the maxillary sinus aspirate; the fourth aspirate was sterile.
D000208:Acute Disease; D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use*; D002433:Cefaclor / Q000627:therapeutic use*; D002506:Cephalexin / Q000031:analogs & derivatives*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005500:Follow-Up Studies; D006192:Haemophilus Infections / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D011859:Radiography; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy*
D002433:Cefaclor; D000658:Amoxicillin; D002506:Cephalexin