Skip to main content
SpringerLink
Log in

Efficacy of penicillin treatment in purulent maxillary sinusitis. A European multicenter trial

Wirksamkeit von Penicillinen bei purulenter Sinusitis maxillaris. Europäische Multicenterstudie

  • Originalia
  • Published:
Infection Aims and scope Submit manuscript

Summary

Three hundred and one patients with maxillary sinusitis participated in a double-blind, randomized study at 11 ENT-clinics in Europe. Sinusitis was diagnosed by the presence of at least two signs and symptoms and sinus X-ray showing more than 6 mm swelling of the maxillary mucosa. A microbiological specimen was obtained by intrasinusal aspiration. The patients were randomly assigned to treatment either with bacampillin 800 mg b. i. d. or with amoxicillin 500 mg t. i. d. for ten days. The most frequently isolated bacteria wereHaemophilus influenzae (94 strains),Streptococcus pneumoniae (66 strains) andBranhamella catarrhalis (12 strains). In 96 of the patients, no microorganisms could be isolated. Beta-lactamase production was found in oneH. influenzae strain and in threeB. catarrhalis strains. Two hundred and seventy-one patients could be evaluated for efficacy at the follow-up visit day 8–25. The overall clinical outcome was the same in both treatment groups. Adverse events such as skin reactions and upper and lower gastrointestinal reactions occurred in 17.4% of the amoxicillin treated patients and in 10.8% of the bacampicillin treated patients (p=0.101).

Zusammenfassung

301 Patienten mit Sinusitis maxillaris wurden in eine randomisiete Doppelblindstudie aufgenommen, an der 11 europäische Hals-Nasen-Ohren-Kliniken beteiligt waren. Die Diagnose der Sinusitis basierte auf mindestens zwei objektiven und subjektiven Symptomen und Röntgenaufnahmen der Nebenhöhlen mit Schwellung der Kieferhöhlenschleimhaut auf mehr als 6 mm Dicke. Durch Kieferhöhlenpunktion wurde eine Probe für die mikrobiologische Untersuchung entnommen. Die Patienten wurden zufallsgemäß zehn Tage lang entweder mit 800 mg Bacampicillin zweimal täglich oder mit 500 mg Amoxicillin dreimal täglich behandelt. Die häufigsten bakteriellen Isolate warenHaemophilus influenzae (94 Stämme),Streptococcus pneumoniae (66 Stämme) undBranhamella catarrhalis (12 Stämme). Bei 96 Patienten konnte kein Mikroorganismus isoliert werden. Bei einem Stamm vonH. influenzae und bei drei Stämmen vonB. catarrhalis wurde Betalaktamasebildung nachgewiesen. 271 Patienten konnten im Hinblick auf das Therapieergebnis durch Kontrolluntersuchungen am 8.–25. Tag ausgewertet werden. Das klinische Gesamtergebnis war bei beiden Therapiegruppen gleich. Nebenwirkungen wie Hautreaktionen oder Beschwerden von seiten des oberen oder unteren Verdauungstraktes traten bei 17,4% der mit Amoxicillin und bei 10,8% der mit Bacampicillin behandelten Patienten auf (p=0,101).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aust, R., Drettner, B. Oxygen tension in the human maxillary sinus under normal and pathological conditions. Acta Otolaryngol. (Stockh.) 78 (1974) 259–264.

    Google Scholar 

  2. Axelsson, A., Brorson, J.-E. The correlation between bacteriological findings in the nose and the maxillary sinus in acute maxillary sinusitis. Laryngoscope 82 (1977) 2003–2011.

    Google Scholar 

  3. Hamory, B. H., Sande, M. A., Sydnor, A. Jr., Seale, D. L., Gwaltney, J. M. Jr. Etiology and antimicrobial therapy of acute maxillary sinusitis. J. Infect. Dis. 139 (1979) 197–202.

    Google Scholar 

  4. Doern, G. V. Branhamella catarrhalis — an emerging human pathogen. Diagn. Microbiol. Infect. 4 (1986) 191–201.

    Google Scholar 

  5. Lundberg, C., Carenfelt, C., Engqvist, S., Nord, C. E. Anaerobic bacteria in maxillary sinusitis. Scand. J. Infect. Dis. (Suppl. 19) (1979) 74–76.

    Google Scholar 

  6. Finegold, S. M. Anerobic infections in otolaryngology. Ann. Otol. Rhinol. Laryngol. 90 (Suppl. 84) (1981) 13–16.

    Google Scholar 

  7. Carenfelt, C., Lundberg, C., Nord, C. E., Wretlind, B. Bacteriology of maxillary sinusitis in relation to quality of the retained secretion. Acta Otolaryngol. (Stockh.) 86 (1978) 298–302.

    Google Scholar 

  8. Renkonen, O.-V. Antibacterial activity of nine oral antibiotics againstStreptococcus pneumoniae, Haemophilus influenzae andBranhamella catarrhalis. Scand. J. Infect. Dis. (Suppl. 39) (1983) 106–108.

    Google Scholar 

  9. Powell, M., Koutsia-Carouzou, C., Voutsinas, D., Seymour, A., Williams, J. D. Resistance of clinical isolates ofHaemophilus influenzae in United Kingdom 1986. Brit. Med. J. 295 (1987) 176–179.

    Google Scholar 

  10. Dabernat, H. Haemophilus influenzae: Epidemiological problems of resistance against ampicillin, tetracycline, chloramphenicol and kanamycin. Infection 15 (Suppl. 3) (1987) S103-S108.

    Google Scholar 

  11. Machka, K., Braveny, I., Dabernat, H., Dornbusch, K., Van Dyck, E., Kayser, F. H., Van Klingeren, B., Mittermayer, H., Perea, E., Powell, M. Distribution and resistance patterns ofHaemophilus influenzae: A European cooperative study. Eur. J. Clin. Microbiol. Infect. Dis. 7 (1988) 14–24.

    Google Scholar 

  12. Gwaltney, J. M., Sydnor, A., Sande, M. A. Etiology and antimicrobial treatment of acute sinusitis. Ann. Otol. Rhinol. Laryngol. 90 (Suppl. 84) (1981) 68–71.

    Google Scholar 

  13. Engquist, S., Lundberg, C., Verge, P. Effects of drainage in the treatment of acute maxillary sinusitis. Acta Otolaryngol. (Stockh.) 95 (1983) 153–159.

    Google Scholar 

  14. Slavin, R. G. Sinusitis. J. Allergy Clin. Immunol. 73 (1984) 712–716.

    Google Scholar 

  15. Bergan, T.: Tissue levels of oral antibiotics in the sinus mucosa. Eur. J. Clin. Microbiol. (1988) (in press).

  16. Nordbring, F. Review of side-effects of aminopenicillins. Infection 7 (Suppl. 5) (1979) S503-S506.

    Google Scholar 

  17. Gipponi, M., Sciutto, C., Accornero, L., Bonassi, S., Raso, C., Vignolo, C., Cafiero, F. Assessing modifications of the intestinal bacterial flora in patients on long-term oral treatment with bacampicillin or amoxicillin: a random study. Chemioterapia 4 (1985) 214–217.

    Google Scholar 

Download references

Authors
  1. C. E. Nord
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

The study group included: Dr.L. Andreasson, ENT Department, Malmö Almänna Sjukhus, S-21401 Malmö; Dr.R. Aust, ENT Department, University Hospital, S-751 85 Uppsala; Prof.F. Franschini, Cattedra di Chemioterapia, Università degli studi di Milano, Via Vanveitelli 32, I-20199 Milano; Dr.H. Neumann, Hanusch Krankenhaus, Heinrich-Collin-Str. 30, A-1140 Wien; Dr.G. Oberascher, HNO-Abteilung, Landeskrankenhaus Salzburg, MÜllner Hauptstr. 48, A-5020 Salzburg; Prof.G. Pesavento, Primaro ORL, Ospedale Civile Regionale, Via Rodolfi 6, I-36100 Vicenza; Dr.P. Schenk, II Univ. HNO-Klinik, Alser Str. 4, A-1030 Wien; Dr.S. Skaftasson, ENT Department, Borgaspitalinn, IS-101 Reykjavik; Dr.M. Sorri, Pohjan Scotilassairaala, SF-90220 Oulo; Prof.G. Sulsenti, Primario ORL, Ospecale Castelsanpietro, I-40138 Bologna; Dr.R. Willminger, HNO-Abteilung, Krankenhaus Lainz, Wolkenbergenstr. 1, A-1130 Wien; Dr.J. Ylikoski, Keskussotilassairaala 1, PL 105, SF-00251 Helsinki; Dr.M. Blomquist, Södertalje, S-15185 Reprint requests to: Prof.C. E. Nord.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nord, C.E. Efficacy of penicillin treatment in purulent maxillary sinusitis. A European multicenter trial. Infection 16, 209–214 (1988). https://doi.org/10.1007/BF01650753

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01650753

Keywords

Search

Navigation