Comparison of the Effectiveness of Levofloxacin and Amoxicillin‐Clavulanate for the Treatment of Acute Sinusitis in Adults

Abstract

In this comparative trial, outpatients with acute sinusitis were randomly assigned to receive levofloxacin (500 mg orally once daily) or amoxicillin-clavulanate (500/125 mg orally 3 times daily) for 10 to 14 days. The success rates (cured and improved) 2 to 5 days after the end of treatment were 88.4% for the 267 clinically evaluable patients who received levofloxacin and 87.3% for the 268 clinically evaluable patients who received amoxicillin-clavulanate. Drug-related adverse events occurred in a smaller percentage of patients in the levofloxacin treatment group (7.4%) than in the amoxicillin-clavulanate treatment group (21.2%). The most common of these were nausea, diarrhea, vaginitis, and abdominal pain for levofloxacin-treated patients and diarrhea, vaginitis, nausea, genital moniliasis, abdominal pain, vomiting, and flatulence for amoxicillin-clavulanate-treated patients. The results of this study show that once-daily administration of levofloxacin is as effective and better tolerated than amoxicillin-clavulanate administered 3 times daily for treating acute sinusitis in adult outpatients.

A comparative study between amoxicillin + clavulanic acid and levofloxacin in the management of acute maxillary sinusitis at RIMS, Ranchi

“…Clarithromycin and amoxicillinclavulanate also showed similar results. [11][12][13] In a study conducted by Wald et al to compare amoxicillin and amoxicillin-clavulanate with placebo amongst 93 children in a 10 day trial. They found that the cure rate amongst children who received antibiotics was 67%, whereas only 43% of those receiving placebo showed resolution.…”

Fluoroquinolones compared with -lactam antibiotics for the treatment of acute bacterial sinusitis: a meta-analysis of randomized controlled trials

“…Two additional trials eligible for inclusion were detected after a secondary search on the Scopus database, but no additional trials were identified in the Cochrane Central Register of Controlled Trials. A total of 11 trials [21][22][23][24][25][26][27][28][29][30][31] were included in the meta-analysis ( Figure 1). The 2 reviewers independently reached the same conclusions regarding studies to be included.…”

“…In addition to the treatments being compared in these studies, adjunctive medications for symptomatic relief, mostly decongestants, antihistamines and analgesics, were permitted in 8 of the trials. 22,[24][25][26][27][28][29][30] Two of these trials reported the percentage of patients using such medications: 76% in one study 28 and 83.5% in the other.…”

“…Adequate randomization procedures were reported in 6 of the 11 trials, 22,23,24,[28][29][30] allocation concealment was reported in 3 trials, 22,24,31 masking of the intervention was reported in 5 trials, 22,24,26,28,29 information on patient withdrawals from the trials was reported in 7 trials, 22,25-30 crossovers of patients between treatment arms were reported in 1 trial, 27 and violation of the inclusion criteria was reported in 4 trials. 26,28,29,31 In 10 of the 11 trials, the fluoroquinolone was the experimental treatment and the β-lactam antibiotic the comparator; in the other trial, the fluoroquinolone (levofloxacin) served as CMAJ • March 25, 2008 • 178 (7) 8 84 47 7…”

True Epilepsy Unmasked in a Case of Apparent Conversion Disorder

“…7 Furthermore, gastrointestinal disorders are the most common adverse reactions observed with use of levofloxacin (5.1%). 8,9 These reactions include diarrhea, nausea, flatulence, abdominal pain, dyspepsia, taste perversion, and vomiting. Chronic medical conditions such as chronic renal failure, antihypertensive medications such as valsartan, and gout treatments such as allopurinol are known to cause taste disturbances.…”