A randomized controlled trial of 5-day regimen of azithromycin and a 10-day regimen of co-amoxiclav for treatment of acute sinusitis

Acute sinusitis constitutes a significant portion of health service utilization globally both in- and out-patient as well as emergency department visits, with 83% resulting in a prescription for an antibiotic. This study compared the efficacy of a 5-day regimen of azithromycin (a macrolid antibiotic) with a 10-day regimen of co-amoxiclav (combination of an aminopenicillin with a betalactamase inhibitor) for the treatment of acute sinusitis.Patients and A total of 76 subjects with acute sinusitis were randomly assigned in two groups, azithromycin (n=40) and co-amoxiclav (n=36). One group received azithromycin, 500mg in the first day and 250mg for 4 days and the other group received co-amoxiclav 625mg, 3 times a day for 10 days. Patients were visited 4 times during the study (baseline, phone call, end of treatment, end of study) and regression/progression of their symptoms and their response to the treatment was evaluated. There was no significant difference between the two group's demographic and clinical presentations. Duration of regression of the symptoms in the azithromycin group was significantly shorter than the co-amoxiclav group (7.6 days versus 10.6, p=0.03). Clinical success rate at end of the study was 80% for azithromycin and 66.7% for co-amoxiclav (p=0.025). Clinical success rates among females in both groups seemed to be higher than males, but this difference was not statistically significant (p=0.13). Results revealed that azithromycin regimen is more efficient, has less side effects, and required shorter treatment period. Patients were able to tolerate the medications better with a higher compliance and less economic cost than co-amoxiclav regimen.