zithromax and erythromycin-stearate

In this study, we aimed to evaluate the role of azithromycin in the treatment of acute infraorbital space infection.. Sixty patients (39 men and 21 women; age range, 18 to 47 years) who had acute infraorbital space infection with pain, swelling, and general malaise were included in the study. After initial surgical therapy, patients were randomly allocated to receive either 500 mg azithromycin once daily for 3 days, 250 mg erythromycin stearate every 6 hours for 3 days, or no antibiotic. Patients were assessed at the time of admission and after 1, 2, 3, and 7 days. Pain, swelling, cervical lymphadenopathy, and sublingual temperature were assessed at each visit. Data were collected, and all groups were compared for differences in pain and swelling using the Mann-Whitney U test and for differences in lymphadenopathy and sublingual temperature using Fisher's exact test.. At the time of admission, no 2 groups were statistically different at the.05 level in relation to age, gender, and presenting clinical signs or symptoms. At days 2 and 3, patients who received azithromycin had a significant reduction in pain (P =.002 and P =.02, respectively) and swelling (P =.001 and P =.013, respectively) compared with those who received no antibiotic. At day 3, patients who received erythromycin had a significant reduction in pain (P =.03) and swelling (P =.046) compared with those who received no antibiotic. In a comparison of the patients who received azithromycin with those who received erythromycin, there was no significant difference (P >.05) in the reduction of pain at any time of the study. However, at day 2, patients who received azithromycin had a significantly greater reduction in swelling (P =.002) than those who received erythromycin. In relation to the percentage of the patients with cervical lymphadenopathy and raised sublingual temperature (>37.2 degrees C), no 2 groups were statistically different at any time of the study. After 3 days of treatment, patients who received the antibiotics were clinically improved, and all patients (n = 60 patients) reviewed after 7 days had resolution of their clinical signs and symptoms.. This study emphasizes the importance of surgical drainage and proves that both azithromycin and erythromycin are effective adjunctive treatments in the therapy of relatively mild odontogenic orofacial infections.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Chi-Square Distribution; Drainage; Erythromycin; Eye Infections, Bacterial; Female; Focal Infection, Dental; Humans; Male; Middle Aged; Orbital Diseases; Statistics, Nonparametric; Tooth Extraction; Treatment Outcome

The ability of antibiotics to penetrate the target organs is an important factor for the clinical effects and side effects in the treatment of infection. In the present study, the comparative tissue distribution of 4 kinds of macrolide antibiotics was determined in rats. After oral administration of 20 mg/kg, roxithromycin (RXM) had the highest plasma concentration, and clarithromycin (CAM) has the second highest. The Cmax of RXM and CAM were 2.7 and 1.0 micrograms/ml, respectively. On the other hand, both levels of erythromycin-stearate (EM-S) and azithromycin (AZM) were extremely low, with a Cmax of 0.1 microgram/ml. Concentration of the 4 compounds were measurable in the liver, kidney, spleen, lung and heart. The concentration in all tissues for each compound were significantly higher than those in the plasma. AZM had the most sustained and the highest tissue levels. The distribution patterns of RXM and AZM were almost similar to the case of EM-S, in that the highest tissue concentration was observed in the liver, followed in descending order by concentration in the kidney, spleen, lung and heart. On the other hand, CAM had the highest concentration in the lung, and was moderated in the liver. Major clinical indications are infections of the respiratory tracts, and commonly reported side-effects are hepatotoxity. Therefore, it is worth noting that the lung levels of CAM were significantly higher than in the liver, as the separation of clinical effects and side-effects.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Clarithromycin; Erythromycin; Male; Organ Specificity; Rats; Rats, Wistar; Roxithromycin