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Eradication of pathogens from the nasopharynx after therapy of acute maxillary sinusitis with low- or high-dose amoxicillin/clavulanic acid.
Int J Antimicrob Agents. 2005 Nov; 26(5):416-9.IJ

Abstract

The growing resistance of Streptococcus pneumoniae to penicillin can be overcome by increasing the dose of the penicillin administered. This generated the recommendation that the adult dose of amoxicillin for the treatment of acute maxillary sinusitis (AMS) be increased from 1.5 g/day to 4.0 g/day. The objective of this study was to investigate whether the higher dose of amoxicillin is more effective than the previously recommended dose in eradicating S. pneumoniae from the nasopharynx of patients who present with AMS. Nasopharyngeal cultures obtained from 58 patients with AMS were studied: 30 received amoxicillin 1.5 g/day given in divided doses three times a day for 10 days (amoxicillin/clavulanic acid 4:1 formulation) and 28 were treated with amoxicillin 4.0 g/day given in divided doses twice a day for 10 days (amoxicillin/clavulanic acid 16:1 formulation). Seventy-one potentially pathogenic organisms were isolated: S. pneumoniae (27 isolates), Haemophilus influenzae non-type b (25), Moraxella catarrhalis (5), Streptococcus pyogenes (5) and Staphylococcus aureus (9). The number of S. pneumoniae isolates in the 1.5 g/day group was reduced from 14 to 9 (2 intermediately resistant and 3 highly resistant). In contrast, the number of S. pneumoniae isolates in the 4.0 g/day group was reduced from 13 to 2 (1 highly resistant) (P<0.05). No differences were noted in the eradication rate of other groups of isolates, which were all susceptible to amoxicillin/clavulanic acid. These data illustrate the superiority of 4.0 g/day amoxicillin/clavulanic acid compared with 1.5 g/day amoxicillin/clavulanic acid in the eradication of S. pneumoniae from the nasopharynx.

Authors+Show Affiliations

Department of Pediatrics, Georgetown University School of Medicine and Alachua General and North Florida Regional Hospitals, Gainesville, FL, USA. ib6@georgetown.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16226017

Citation

Brook, Itzhak, et al. "Eradication of Pathogens From the Nasopharynx After Therapy of Acute Maxillary Sinusitis With Low- or High-dose Amoxicillin/clavulanic Acid." International Journal of Antimicrobial Agents, vol. 26, no. 5, 2005, pp. 416-9.
Brook I, Foote PA, Hausfeld JN. Eradication of pathogens from the nasopharynx after therapy of acute maxillary sinusitis with low- or high-dose amoxicillin/clavulanic acid. Int J Antimicrob Agents. 2005;26(5):416-9.
Brook, I., Foote, P. A., & Hausfeld, J. N. (2005). Eradication of pathogens from the nasopharynx after therapy of acute maxillary sinusitis with low- or high-dose amoxicillin/clavulanic acid. International Journal of Antimicrobial Agents, 26(5), 416-9.
Brook I, Foote PA, Hausfeld JN. Eradication of Pathogens From the Nasopharynx After Therapy of Acute Maxillary Sinusitis With Low- or High-dose Amoxicillin/clavulanic Acid. Int J Antimicrob Agents. 2005;26(5):416-9. PubMed PMID: 16226017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eradication of pathogens from the nasopharynx after therapy of acute maxillary sinusitis with low- or high-dose amoxicillin/clavulanic acid. AU - Brook,Itzhak, AU - Foote,Perry A, AU - Hausfeld,Jeffrey N, Y1 - 2005/10/12/ PY - 2005/07/07/received PY - 2005/08/04/accepted PY - 2005/10/18/pubmed PY - 2006/1/26/medline PY - 2005/10/18/entrez SP - 416 EP - 9 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 26 IS - 5 N2 - The growing resistance of Streptococcus pneumoniae to penicillin can be overcome by increasing the dose of the penicillin administered. This generated the recommendation that the adult dose of amoxicillin for the treatment of acute maxillary sinusitis (AMS) be increased from 1.5 g/day to 4.0 g/day. The objective of this study was to investigate whether the higher dose of amoxicillin is more effective than the previously recommended dose in eradicating S. pneumoniae from the nasopharynx of patients who present with AMS. Nasopharyngeal cultures obtained from 58 patients with AMS were studied: 30 received amoxicillin 1.5 g/day given in divided doses three times a day for 10 days (amoxicillin/clavulanic acid 4:1 formulation) and 28 were treated with amoxicillin 4.0 g/day given in divided doses twice a day for 10 days (amoxicillin/clavulanic acid 16:1 formulation). Seventy-one potentially pathogenic organisms were isolated: S. pneumoniae (27 isolates), Haemophilus influenzae non-type b (25), Moraxella catarrhalis (5), Streptococcus pyogenes (5) and Staphylococcus aureus (9). The number of S. pneumoniae isolates in the 1.5 g/day group was reduced from 14 to 9 (2 intermediately resistant and 3 highly resistant). In contrast, the number of S. pneumoniae isolates in the 4.0 g/day group was reduced from 13 to 2 (1 highly resistant) (P<0.05). No differences were noted in the eradication rate of other groups of isolates, which were all susceptible to amoxicillin/clavulanic acid. These data illustrate the superiority of 4.0 g/day amoxicillin/clavulanic acid compared with 1.5 g/day amoxicillin/clavulanic acid in the eradication of S. pneumoniae from the nasopharynx. SN - 0924-8579 UR - https://www.unboundmedicine.com/medline/citation/16226017/Eradication_of_pathogens_from_the_nasopharynx_after_therapy_of_acute_maxillary_sinusitis_with_low__or_high_dose_amoxicillin/clavulanic_acid_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(05)00252-9 DB - PRIME DP - Unbound Medicine ER -