The efficacy of azithromycin in the treatment of acute infraorbital space infection.
OBJECTIVE
In this study, we aimed to evaluate the role of azithromycin in the treatment of acute infraorbital space infection.


METHODS
Sixty patients (39 men and 21 women; age range, 18 to 47 years) who had acute infraorbital space infection with pain, swelling, and general malaise were included in the study. After initial surgical therapy, patients were randomly allocated to receive either 500 mg azithromycin once daily for 3 days, 250 mg erythromycin stearate every 6 hours for 3 days, or no antibiotic. Patients were assessed at the time of admission and after 1, 2, 3, and 7 days. Pain, swelling, cervical lymphadenopathy, and sublingual temperature were assessed at each visit. Data were collected, and all groups were compared for differences in pain and swelling using the Mann-Whitney U test and for differences in lymphadenopathy and sublingual temperature using Fisher's exact test.


RESULTS
At the time of admission, no 2 groups were statistically different at the.05 level in relation to age, gender, and presenting clinical signs or symptoms. At days 2 and 3, patients who received azithromycin had a significant reduction in pain (P =.002 and P =.02, respectively) and swelling (P =.001 and P =.013, respectively) compared with those who received no antibiotic. At day 3, patients who received erythromycin had a significant reduction in pain (P =.03) and swelling (P =.046) compared with those who received no antibiotic. In a comparison of the patients who received azithromycin with those who received erythromycin, there was no significant difference (P >.05) in the reduction of pain at any time of the study. However, at day 2, patients who received azithromycin had a significantly greater reduction in swelling (P =.002) than those who received erythromycin. In relation to the percentage of the patients with cervical lymphadenopathy and raised sublingual temperature (>37.2 degrees C), no 2 groups were statistically different at any time of the study. After 3 days of treatment, patients who received the antibiotics were clinically improved, and all patients (n = 60 patients) reviewed after 7 days had resolution of their clinical signs and symptoms.


CONCLUSIONS
This study emphasizes the importance of surgical drainage and proves that both azithromycin and erythromycin are effective adjunctive treatments in the therapy of relatively mild odontogenic orofacial infections.
Al-Belasy
Fouad A
FA
Oral Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt. AlBelasy@netscape.net
Hairam
Ashraf R
AR
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004322:Drainage; D004917:Erythromycin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000188:drug therapy*; D005260:Female; D005491:Focal Infection, Dental / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D014081:Tooth Extraction; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D017963:Azithromycin; C011462:erythromycin stearate