Efficacy of azithromycin compared with spiramycin in the treatment of odontogenic infections.
Sixty patients with acute odontogenic infections were randomly allocated to oral treatment with azithromycin 500 mg/day once-daily for three days (n = 30) or spiramycin 3,000,000 units three-times daily for seven days (n = 30). Baseline and post-treatment oral specimens were collected from patients to test for pathogenic bacteria. Aerobic bacteria were tested using the Kirby-Bauer disc diffusion method, and anaerobic bacteria with a broth microdilution method, for their susceptibility to azithromycin and spiramycin. A greater incidence of resistance was found in the spiramycin group than in the azithromycin group. The bacteriological assessment showed that the normal balance of microflora was re-established in 67% of patients treated with azithromycin vs 53% in the group treated with spiramycin. Clinical cure was higher in the azithromycin treatment group (97%) compared with the spiramycin group (73%). These results indicate that three-day azithromycin, possibly because of its unusual pharmacokinetics, is more effective than seven-day spiramycin in the treatment of odontogenic infections.
Institute of Microbiology, University of Catania, Italy.
A M
AM
Lo Bue
R
R
Sammartino
G
G
Chisari
M R
MR
Gismondo
G
G
Nicoletti
D017963:Azithromycin; D001424:Bacterial Infections / Q000188:drug therapy*; D004917:Erythromycin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000188:drug therapy / Q000382:microbiology; D015572:Spiramycin / Q000009:adverse effects / Q000627:therapeutic use*; D014076:Tooth Diseases / Q000188:drug therapy* / Q000382:microbiology
D004917:Erythromycin; D015572:Spiramycin; D017963:Azithromycin