Evaluation of cefixime in the treatment of bacterial maxillary sinusitis.
The efficacy and safety of cefixime, the first oral third-generation cephalosporin, were evaluated in a multicenter clinical trial involving 118 adult patients with acute sinusitis or acute exacerbations of chronic sinusitis. Patients received a single daily dose of 400 mg of cefixime for a mean duration of 10 days; 106 patients completed a course of therapy. Clinical cure and improvement were achieved in 90% of these patients (61% cured and 29% improved). Among the patients evaluated again 2 weeks after therapy, 91% had a sustained clinical cure or improvement. Sinus exudate specimens were obtained from all patients by transantral puncture before therapy. Pathogens were isolated from 76 patients (66%), the most common pathogens being Haemophilus influenzae, alpha-hemolytic streptococci, and Streptococcus pneumoniae. Eighty-six percent of pathogens were presumed eradicated. Three patients discontinued therapy because of side effects. The most frequently reported adverse effects were gastrointestinal, with 20% of patients reporting diarrhea. Cefixime was effective in the treatment of bacterial sinus infections in adults and was well tolerated.
Matthews
B L
BL
Department of Otolaryngology, Bowman Gray-School of Medicine of Wake Forest University, Winston-Salem, NC 27157.
Kohut
R I
RI
Edelstein
D R
DR
Rybak
L P
LP
Rapp
M
M
McCaffrey
T V
TV
Kimmelman
C P
CP
Parnes
S M
SM
Marinaccio
A T
AT
Kohlbrenner
V M
VM
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D020682:Cefixime; D002439:Cefotaxime / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011859:Radiography; D012008:Recurrence; D013396:Suction; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D020682:Cefixime; D002439:Cefotaxime