A Randomized Controlled Trial of 5-Day Regimen of Azithromycin and a 10-Day Regimen of Co-amoxiclav for Treatment of Acute Sinusitis


Abdolaziz Rastegar Lari 1 , * , Alireza Ghaffariyeh 2 , Noushi Etesam 3 , Hamid Mostafavi 3 , Reza Alaghehbandan 4

1 Antimicrobial Resistance Research Center, Department of Microbiology, Iran University of Medical Sciences, Tehran, IR Iran

2 Kosar Hospital, Shiraz, Fars, IR Iran

3 Exir Pharmaceutical Company, Tehran, IR Iran

4 Faculty of Medicine, Memorial University of Newfoundland, St. Johns, NL, Canada

How to Cite: Rastegar Lari A, Ghaffariyeh A, Etesam N, Mostafavi H, Alaghehbandan R. A Randomized Controlled Trial of 5-Day Regimen of Azithromycin and a 10-Day Regimen of Co-amoxiclav for Treatment of Acute Sinusitis, Arch Clin Infect Dis. Online ahead of Print ; 5(3):137-141.


Archives of Clinical Infectious Diseases: 5 (3); 137-141
Article Type: Research Article


Background: Acute sinusitis constitutes a significant portion of health service utilization globally both in- and outpatient 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 coamoxiclav (combination of an aminopenicillin with a betalactamase inhibitor) for the treatment of acute sinusitis.

Patients and Methods: 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.

Results: There was no significant difference between the two groups' 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).

Conclusion: 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.

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