Treatment of Acute Maxillary Sinusitis — Comparing Cefpodoxime Proxetil with Amoxicillin

Abstract

In order to evaluate the clinical efficacy and tolerance of cefpodoxime proxetil, compared with that of amoxicillin in the treatment of acute bacterial maxillary sinusitis, a randomized, double-blind, parallel group comparative study was performed. A total of 286 adults patients were included at 12 centres, each treatment group consisting of 143 patients. Each patient was treated for 10 days and observed before and after treatment. The observations included clinical, roentgenological, bacteriological and laboratory examinations. At inclusion, the most common pathogens were Haemophilus influenzae (24%) and Streptococcus pneumoniae (17%). In the per protocol analysis, 117 patients in the cefpodoxime group and 113 in the amoxicillin group were evaluable for clinical efficacy. The clinical response rates were 96% and 91%, respectively. The corresponding figures in the intent-to-treat analysis were 130 and 128 patients, with clinical response rates of 93% and 88%, respectively. Cefpodoxime proxetil proved clinically as effective as amoxicillin in the treatment of acute bacterial maxillary sinusitis. It was more effective in eradicating H. influenzae and was more efficient in improving the radiological score. Adverse events were reported in 20% of cefpodoxime cases and in 16% of amoxicillin cases. There was no statistically significant difference between the groups.

Management of acute bacterial rhinosinusitis: current issues and future perspectives

“…influenzae and most S . pneumoniae strains (including those with intermediate levels of penicillin resistance) (41). Cefprozil is a well‐tolerated cephalosporin, and its efficacy against S .…”

“…Cefuroxime axetil is an oral cephalosporin with good efficacy against H. influenzae (39,40) but much lower activity against S. pneumoniae. Cefpodoxime proxetil is comparable with cefuroxime in its activity against H. influenzae and most S. pneumoniae strains (including those with intermediate levels of penicillin resistance) (41). Cefprozil is a well-tolerated cephalosporin, and its efficacy against S. pneumoniae is similar to that of cefuroxime or cefpodoxime (42).…”

Oral third-generation cephalosporin cefpodoxime in the therapy of respiratory infections

“…Острый бактериальный синусит В настоящее время большинство оториноларингологов рассматривают амоксициллин/клавуланат в качестве препарата выбора для лечения острого бактериального риносинусита (ОБРС). В клинических исследованиях у пациентов с ОБРС цефподоксим (в дозе 200 мг 2 р/сут внутрь в течение 5-10 дней) продемонстрировал по меньшей мере сравнимую эффективность с амоксициллином (500 мг 3 р/сут 10 дней) и амоксициллином/клавуланатом (625 мг 3 р/сут 8 дней) [18,19].…”

Upper respiratory tract infections: etiology, current treatment, and experience with fluoroquinolones

“…Both cefuroxime and cefpodoxime appear to have good activity against intermediately resistant pneumococci. For example, in one randomized, double‐blind study of 286 patients with acute maxillary sinusitis, cefpodoxime proved as effective as amoxycillin [6]. Certain cephalosporins, such as cefuroxime and cefpodoxime, therefore, have a role as second‐line treatment for acute sinusitis.…”