cefuroxime-axetil and Respiratory-Tract-Infections

Cefuroxime axetil, a prodrug of the cephalosporin cefuroxime, has proven in vitro antibacterial activity against several gram-positive and gram-negative organisms, including those most frequently associated with various common community-acquired infections. In numerous randomised, controlled trials, 5 to 10 days' treatment with oral cefuroxime axetil (250 or 500 mg twice daily) was an effective treatment in patients with upper (URTI) and lower respiratory tract infections (LRTI) as assessed by clinical and bacteriological criteria. The drug was as effective as several other cephalosporins, quinolones, macrolides and amoxicillin/clavulanic acid. Shorter courses (5 to 10 days') of cefuroxime axetil were at least as effective as a 10 day course. Furthermore, sequential therapy with intravenous cefuroxime (750 mg 2 or 3 times daily for 2 to 5 days) followed by oral cefuroxime axetil (500 mg twice daily for 3 to 8 days) proved an effective treatment in adult patients with community-acquired pneumonia (CAP). This approach provided similar efficacy to intravenous ampicillin/sulbactam followed by oral amoxicillin/clavulanic acid, a full parenteral course of cefuroxime, or intravenous then oral azithromycin or clarithromycin. Additionally, cefuroxime axetil was an effective treatment in patients with genitourinary, skin and soft-tissue infections, and erythema migrans associated with early stage Lyme disease. The drug is well tolerated by adult and paediatric patients, with adverse effects that are consistent with those of other cephalosporins. The majority of adverse events (primarily gastrointestinal disturbances) were mild to moderate in intensity and reversible upon discontinuation of treatment, with very few serious adverse events reported.. Cefuroxime axetil is a broad spectrum antibacterial agent with a pharmacokinetic profile that permits convenient twice-daily administration. The drug is an effective and well tolerated treatment in patients with various infections, including otitis media, pharyngitis, sinusitis, CAP and acute exacerbations of chronic bronchitis. Cefuroxime axetil proved effective as a component of intravenous/oral sequential therapy in the treatment of CAP, although there are currently no dosage recommendations available for this regimen in some countries. Cefuroxime axetil may be considered as an empirical therapy for a range of community-acquired infections, including those in which beta-lactamase-producing strains of common respiratory pathogens are identified as the causative organisms. In an era of rapidly emerging bacterial resistance, empirical treatment with bacterial agents, potentially preventing the emergence of bacterial resistance to agents such as cefuroxime axetil may ensure the appropriate use of newer antibacterial agents, potentially preventing the emergence of bacterial resistance to these newer drugs.

Topics: Age Factors; Cefuroxime; Cephalosporins; Clinical Trials as Topic; Economics, Pharmaceutical; Female Urogenital Diseases; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Lyme Disease; Male Urogenital Diseases; Respiratory Tract Infections; Skin Diseases

This study summarizes the actual recommendations for cefuroxime axetil treatment in dermatology and general medicine. These include the well known clinical efficacies in therapy of upper and lower respiratory tract infections, genitourinary tract infections and skin and soft tissue infections, but also connective tissue diseases, such as morphea and SCLE. Though the immunomodulatory activity of the drug should be established by further controlled studies, there are some limited literature data, which show the modulatory effect of cefuroxime axetil on the lymphocyte proliferation and the production of selected cytokines.

Topics: Bacterial Infections; Borrelia Infections; Cefuroxime; Connective Tissue Diseases; Cytokines; Dermatitis; Humans; Lymphocytes; Respiratory Tract Infections

Cefprozil was evaluated in four multicentre comparative studies in the treatment of acute respiratory tract infections. In two studies, cefprozil 500 mg q. 12 hours was compared to cefaclor 500 mg q. eight hours for ten days of therapy. Randomization was on a 2:1 (cefprozil:cefaclor) basis in the European centres and 1:1 in North America. The clinical efficacy in acute bronchitis was 88% (284 out of 324 patients) for cefprozil and 88% (183 out of 208) for cefaclor, with successful bacteriological eradication of the causative pathogen in 86% and 82% of the patients, respectively. Amongst the patients with acute exacerbations of chronic bronchitis, the clinical response rate of 80% (59 out of 74) for cefprozil appeared superior to that of cefaclor at 62% (p = 0.067), whilst the bacteriological response rates were 62% (36 out of 58) for cefprozil and 74% (20 out of 27) for cefaclor. In pneumonia, the clinical response rates for cefprozil and cefaclor therapy were similar, 82% vs. 79%, although bacteriological eradication rates were better for cefprozil at 82% than for cefaclor at 71%. In the comparison of cefprozil with cefuroxime axetil, a total of 170 patients were evaluable. The clinical and bacteriological response rates for cefprozil of 95% and 100% were better than those for cefuroxime axetil 500 mg q. 12 hours of 84% and 75%, respectively. In the cefprozil vs. amoxicillin-clavulanate, 500 mg q. eight hours comparative study, the two antibiotics displayed no significant difference in clinical or bacteriological responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Cefaclor; Cefprozil; Cefuroxime; Cephalosporins; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Male; Multicenter Studies as Topic; Pneumonia; Prodrugs; Randomized Controlled Trials as Topic; Respiratory Tract Infections

Community acquired lower respiratory tract infection (CALRTI) is the most common infection requiring hospitalization in the elderly. Sequential antibiotic therapy offers the potential for earlier functional rehabilitation, shorter length of hospital stay and lower costs. We studied the efficacy and safety of an empiric sequential antibiotic therapy with cefuroxime-cefuroxime axetil in elderly patients hospitalized with a CALRTI.. A prospective, randomized, open-label, in-hospital study of cefuroxime IV 750 mg tid for 10 days (IV group) vs cefuroxime 750 mg IV tid for 3 days, followed by cefuroxime-axetil PO 500 mg bid for 7 days (sequence group), when clinical (symptoms improved and fever disappeared) and/or laboratory response [decrease in C-reactive protein (CRP)] occurred.. A total of 142 patients, 71 (mean age: 83.3 (+/-6 SD), M/F ratio: 1.1) in the IV group, and 71 (mean age: 81.5 (+/-7 SD), M/F ratio: 1.5) in the sequence group, were included in the study. Eighty-three (58.4%) presented with radiologically confirmed pneumonia (CAP) and 59 (41.6%) with non-pneumonic LRTI (NPLRTI) (p=ns between study groups). Treatment was considered effective in 84.5% (60/71) of patients in the IV group and 80.3% (57/71) in the sequence group (p=ns). Therapy failed in 15% (21/142) of the study population (p=ns between study groups) and, after day 3 of therapy, 8.45% (6/71) failed in both study groups. By the end of treatment, two patients had died in each study group, and total in-hospital mortality was 8.5% (12/142, p=ns between study groups). The length of hospital stay (LOS) did not differ between the two study groups.. When a favorable clinical or biochemical response occurs on day 3 of IV cefuroxime therapy, further therapy with oral cefuroxime-axetil is as effective and safe as a full course of cefuroxime IV in elderly patients hospitalized with CALRTI. However, LOS was not reduced after sequential antibiotic therapy in this population.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; C-Reactive Protein; Cefuroxime; Community-Acquired Infections; Drug Therapy, Combination; Female; Humans; Length of Stay; Male; Outcome Assessment, Health Care; Prospective Studies; Respiratory Tract Infections; Treatment Outcome

To evaluate the efficacy of antibiotic treatment in children who presented in medical care with respiratory infection and had imaging evidence of sinusitis.. Eighty-two children (4-10 y) with acute respiratory symptoms and ultrasonography findings suggestive of acute rhinosinusitis were enrolled in a randomized, double-blind trial. The sinus findings were confirmed with plain radiographs. The children received either cefuroxime axetil in 125-mg capsules twice a day for 10 d or placebo. Main outcome measures were complete cure in 2 wk and absence of prolonged symptoms or complications.. A total of 72 children (88%) completed follow-up. The sinusitis findings in the ultrasound could be confirmed with plain radiographs in 65 of the 72 patients (90%). The proportion of children completely cured by day 14 was similar in both groups (difference 6%, 95% confidence interval -16% to 29%). Similarly, there was no significant difference in the proportions of children who escaped prolonged disease and complications between the groups (difference 7%, -9% to 24%).. A 10-d course of cefuroxime axetil offered no clinical benefit to children with an acute respiratory illness and imaging evidence of acute sinusitis.

Topics: Acute Disease; Anti-Bacterial Agents; Cefuroxime; Child; Child, Preschool; Double-Blind Method; Female; Humans; Male; Placebos; Respiratory Tract Infections; Sinusitis; Time Factors; Treatment Outcome

Cefprozil was evaluated in four multicentre comparative studies in the treatment of acute respiratory tract infections. In two studies, cefprozil 500 mg q. 12 hours was compared to cefaclor 500 mg q. eight hours for ten days of therapy. Randomization was on a 2:1 (cefprozil:cefaclor) basis in the European centres and 1:1 in North America. The clinical efficacy in acute bronchitis was 88% (284 out of 324 patients) for cefprozil and 88% (183 out of 208) for cefaclor, with successful bacteriological eradication of the causative pathogen in 86% and 82% of the patients, respectively. Amongst the patients with acute exacerbations of chronic bronchitis, the clinical response rate of 80% (59 out of 74) for cefprozil appeared superior to that of cefaclor at 62% (p = 0.067), whilst the bacteriological response rates were 62% (36 out of 58) for cefprozil and 74% (20 out of 27) for cefaclor. In pneumonia, the clinical response rates for cefprozil and cefaclor therapy were similar, 82% vs. 79%, although bacteriological eradication rates were better for cefprozil at 82% than for cefaclor at 71%. In the comparison of cefprozil with cefuroxime axetil, a total of 170 patients were evaluable. The clinical and bacteriological response rates for cefprozil of 95% and 100% were better than those for cefuroxime axetil 500 mg q. 12 hours of 84% and 75%, respectively. In the cefprozil vs. amoxicillin-clavulanate, 500 mg q. eight hours comparative study, the two antibiotics displayed no significant difference in clinical or bacteriological responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Cefaclor; Cefprozil; Cefuroxime; Cephalosporins; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Male; Multicenter Studies as Topic; Pneumonia; Prodrugs; Randomized Controlled Trials as Topic; Respiratory Tract Infections

In a large multinational study, the clinical and bacteriological efficacy of intravenous cefuroxime 750 mg t.i.d. followed by oral cefuroxime axetil 500 mg b.i.d. was compared to that of amoxicillin plus clavulanic acid (CA) administered as 1.2 g intravenously t.i.d. followed by 625 mg orally t.i.d. in the treatment of lower respiratory tract infections in hospitalised patients. A total of 512 patients were entered (256 in each treatment group). All were suffering from pneumonia or acute exacerbations of chronic bronchitis or bronchiectasis and required initial parenteral antibiotic therapy. Parenteral therapy lasted 48 to 72 h and was followed by five days of oral therapy. The clinical responses in the two treatment groups were very similar: 223 of 256 (87.1%) patients were cured or improved with cefuroxime/cefuroxime axetil compared to 220 of 256 (85.9%) with amoxicillin/CA. Positive pre-treatment sputum samples were obtained from 44% of the patients. Clearance rates obtained were again similar: 72.8% with cefuroxime/cefuroxime axetil and 70% with amoxicillin/CA. Ten percent of the isolates were beta-lactamase producers, similar numbers of which were cleared in both groups. Both regimens were generally well tolerated, with only 5% of patients treated with the cefuroxime regimen and 4.3% of patients treated with amoxicillin/CA experiencing drug-related adverse events. Cefuroxime/cefuroxime axetil "follow-on" therapy produces clinical and bacteriological efficacy equivalent to that of amoxicillin/CA, with the advantage of twice daily oral administration.

Topics: Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bronchiectasis; Bronchitis; Cefuroxime; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Male; Middle Aged; Pneumonia; Prodrugs; Respiratory Tract Infections

Topics: Bacterial Infections; Cefuroxime; Cephalosporins; Clinical Trials as Topic; Dose-Response Relationship, Drug; Humans; Prodrugs; Respiratory Tract Infections; Urinary Tract Infections

Cefuroxime-axetil is the first oral broad spectrum cephalosporin to be naturally stable in the presence of bêta-lactamases. The aim of this randomized trial was to evaluate the efficacy and safety of cefuroxime-axetil (250 mg twice daily after meal) with cefadroxil (1 g twice daily during meal) for the treatment of upper respiratory tract infection. In this study 150 patients were enrolled. Before treatment, the two groups were comparable. Clinical success was achieved for 94.3% of the patients treated with cefuroxime-axetil versus 90.4% for cefadroxil. Statistical significance was reached (p less than 0.05) concerning the number of days with facial pain for sinusitis (3 days for the cefuroxime-axetil treated group versus 4 days), the rate of normal tympanum at the second examination (58.3% vs 20% respectively) for otitis, and the number of day with painful dysphagia for tonsillitis (2.6 vs 3.8 days respectively). Cefuroxime-axetil was safe (a few advers events occurred, almost all gastro-intestinal). Cefuroxime-axetil is a safe and effective treatment of upper respiratory tract infections.

Topics: Adolescent; Adult; Aged; Cefadroxil; Cefuroxime; Female; Humans; Male; Middle Aged; Prodrugs; Respiratory Tract Infections

Cefuroxime axetil was compared with cefaclor for the therapy for lower respiratory tract infections. Sixty-one patients were randomized to receive the following drug dosages: (1) cefuroxime axetil, 250 mg orally every 12 hours (21 patients); (2) cefuroxime axetil, 500 mg orally every 12 hours (21 patients); and (3) cefaclor, 500 mg orally every eight hours (19 patients). Of these 61 patients, 80% were male, with a mean age of 59.5 years; 56% had acute pneumonia, and the remainder had an acute bronchitis. Causative pathogens included typical respiratory tract pathogens. Overall, 23 of 27 patients with bronchitis were clinically cured at the end of therapy. Thirty-one of 34 pneumonias were clinically cured or improved at the end of therapy; the three pneumonia treatment failures occurred in the lower dose cefuroxime (n = 2) and cefaclor (n = 1) treatment groups. Overall, bacteriologic cure occurred in 86% of patients treated with 500 mg of cefuroxime axetil compared with 60% of cefaclor-treated patients. Adverse clinical effects were uncommon. From this study, it was concluded that cefuroxime given every 12 hours is at least as clinically efficacious as cefaclor; it is a new oral cephalosporin with pharmacologic and bacterial spectrum advantages over many older agents.

Topics: Acute Disease; Administration, Oral; Adult; Aged; Bacterial Infections; Bronchitis; Cefaclor; Cefuroxime; Cephalexin; Cephalosporins; Clinical Trials as Topic; Drug Therapy; Female; Humans; Male; Middle Aged; Pneumonia; Prodrugs; Random Allocation; Respiratory Tract Infections

Cefuroxime axetil (CAE), an orally absorbed prodrug of cefuroxime, was evaluated for its efficacy and safety in the treatment of upper respiratory tract infections (tonsillitis, pharyngitis, sinusitis and otitis media) in general practice in the United Kingdom. A total of 385 patients aged 14 or over were enrolled in a randomized study to compare cefuroxime axetil 250 mg b.d. for 5 days with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. for 5 days. Of 175 clinically assessable patients treated with cefuroxime axetil, 136 were cured and 33 improved (97% success rate). Of 188 assessable patients given Augmentin, 155 were cured and 29 improved (98% success rate). Sixty-four patients treated with cefuroxime axetil were evaluable for bacteriological response: 47 (73%) of the causative pathogens were eradicated, as compared with 62 of 86 (72%) in patients treated with Augmentin. Thirteen out of 181 (7%) patients treated with cefuroxime axetil experienced drug-related adverse events, including 4% with diarrhoea. In the Augmentin group 24 out of 204 (12%) patients had a drug-related adverse event, including 5% with diarrhoea. In conclusion, cefuroxime axetil at a dose of 250 mg b.d. appears to be as safe and effective as Augmentin at the higher dose of 375 mg t.d.s. in the treatment of upper respiratory tract infections.

Topics: Adolescent; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Cefuroxime; Cephalosporins; Clavulanic Acids; Drug Combinations; Female; Humans; Male; Middle Aged; Random Allocation; Respiratory Tract Infections

We assessed oral cefuroxime axetil in an open study of 30 patients with lower respiratory tract infection and then compared oral cefuroxime with oral amoxycillin in a randomized double blind study in a further 40 patients. Satisfactory clinical responses were obtained in 73% of patients receiving cefuroxime axetil 500 mg tid in the open study, and in the comparative study in 71% of patients receiving cefuroxime axetil 500 mg bd, in 60% of patients receiving cefuroxime axetil 500 mg tid and in 63% of patients receiving amoxycillin 500 mg tid. There were no significant differences in response rates between the three regimens in the comparative study. There were no important adverse effects in any of the patients. Oral cefuroxime axetil is safe and effective in the therapy of lower respiratory tract infections.

Topics: Administration, Oral; Amoxicillin; Cefuroxime; Cephalosporins; Female; Humans; Male; Middle Aged; Peak Expiratory Flow Rate; Respiratory Tract Infections; Sputum

Neuroleptic malignant syndrome is an uncommon but potentially fatal side effect of antipsychotic drug treatment. Several serious complications have been associated with neuroleptic malignant syndrome, such as acute renal failure, deep venous thrombosis, pulmonary embolism and aspiration pneumonia. Reports on infections other than aspiration pneumonia appear, from the literature, to be uncommon. Four cases of infection (three cases of upper respiratory tract infection and one case of urinary tract infection) which developed during the course of neuroleptic malignant syndrome are reported and pathophysiological mechanisms underlying their presentation are suggested.

Topics: Acute Kidney Injury; Adolescent; Adult; Aged; Anti-Bacterial Agents; Antipsychotic Agents; Cefuroxime; Dehydration; Female; Fluid Therapy; Humans; Male; Neuroleptic Malignant Syndrome; Respiratory Tract Infections

Topics: Animals; Cefuroxime; Cost-Benefit Analysis; Humans; Lyme Disease; Prodrugs; Respiratory Tract Infections

Topics: Aged; Cefuroxime; Chronic Disease; Drug Evaluation; Humans; Lung Diseases; Male; Middle Aged; Respiratory Tract Infections

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Aging; Cefuroxime; Female; Humans; Intestinal Absorption; Male; Middle Aged; Prodrugs; Respiratory Tract Infections

The tolerability, safety, and efficacy of cefuroxime axetil suspension was studied in 36 children (aged 3 mo to 12 y) who had been hospitalized for respiratory tract or soft-tissue infections. After receiving parenteral antibiotics for a mean of 3.7 days, children were discharged home to receive cefuroxime axetil suspension at doses of 10, 15, or 20 mg/kg every 8 or 12 hours for a mean of 8.2 days. One child was lost to follow-up. Three of 35 evaluated patients were withdrawn from therapy because of adverse events, one of which was a drug-related hypersensitivity reaction. Of the 32 children who completed therapy, 9 developed mild reactions including oral thrush, diarrhea, or diaper dermatitis; none were withdrawn from therapy. Complete clinical cure occurred in 28 children (80 percent); 4 (11.4 percent) were clinically improved but still required an additional antibiotic within one week of completing therapy with cefuroxime axetil suspension. This favorable tolerability and safety of cefuroxime axetil suspension warrants further efficacy trials in pediatric patients.

Topics: Anti-Bacterial Agents; Cefuroxime; Cellulitis; Child; Child, Preschool; Drug Hypersensitivity; Drug Tolerance; Female; Humans; Infant; Injections, Intravenous; Male; Prodrugs; Random Allocation; Respiratory Tract Infections; Suspensions; Treatment Outcome

The pharmacokinetics of cefuroxime axetil (RS3 formulation) were studied in 20 elderly patients following admission for lower respiratory or urinary tract infection. The mean age was 83.9 years. A 12-hourly dose of 250 mg was given for five days. The mean time to attain maximum serum concentration was 3.2 h with a mean peak concentration of 8.5 mg/l. The mean serum elimination half-life was 3.5 h and the AUC0-infinity 60.4 mg/h.l. There was no accumulation of the drug in the patients studied after five days treatment. The data suggest that the standard dosage regimen is adequate in the sick elderly patient.

Topics: Administration, Oral; Aged; Aged, 80 and over; Cefuroxime; Drug Administration Schedule; Female; Humans; Male; Respiratory Tract Infections; Urinary Tract Infections

Topics: Bacterial Infections; Cefuroxime; Cephalosporins; Drug Resistance, Microbial; Humans; Prodrugs; Respiratory Tract Infections; Urinary Tract Infections

Topics: Administration, Oral; Anti-Bacterial Agents; Biological Availability; Blister; Cefoxitin; Cefuroxime; Humans; Metabolic Clearance Rate; Respiratory Tract Infections

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin; Anti-Bacterial Agents; Bronchitis; Cefuroxime; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Pneumonia, Bacterial; Respiratory Tract Infections; Single-Blind Method; Treatment Outcome

Topics: Alabama; Anti-Bacterial Agents; Bronchitis; Cefaclor; Cefuroxime; Clinical Trials as Topic; Community-Acquired Infections; Drug Combinations; Humans; Pneumonia, Bacterial; Reproducibility of Results; Respiratory Tract Infections; Safety; Treatment Failure; Treatment Outcome

Cefuroxime axetil tablets were given to 12 children (aged 19 months to 13.5 years) for a total of 14 episodes of lower respiratory tract infection. Doses ranged from 15 to 32 mg/kg/day. Six infections were regarded as cured and seven improved. In four cases, Haemophilus influenzae was present at the end of treatment. Serum levels of cefuroxime showed great variability. Absorption and penetration of the drug into the lower respiratory mucosa may not be sufficient to kill organisms which are sensitive in vitro. Cefuroxime axetil tablets were acceptable to most children.

Topics: Acute Disease; Adolescent; Cefuroxime; Cephalosporins; Child; Child, Preschool; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Respiratory Tract Infections

Topics: Adolescent; Adult; Aged; Cefuroxime; Cephalosporins; Drug Evaluation; Family Practice; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Respiratory Tract Infections

Cefuroxime axetil (CAE) is a prodrug of cefuroxime which is suitable for oral administration, being hydrolysed by non-specific esterases to release cefuroxime (CXM) into the bloodstream. This study was performed in four centres in the UK to investigate the efficacy and safety of CAE administered at a dosage of either 250 mg t.d.s. or 500 mg b.d. for the treatment of community-acquired lower respiratory tract infections. Of the 69 clinically assessable patients, 33 out of 34 (97%) patients on 250 mg t.d.s. and 31 out of 35 (89%) on 500 mg b.d. were cured or improved. Positive bacteriology was obtained from 43 (61%) of the pretreatment sputum samples, of which 35 (51%) were assessable: the pathogen was eradicated from 14 out of 16 (88%) on 250 mg. t.d.s. and 16 out of 19 (84%) on 500 mg b.d. The most common infecting organism was H. influenzae, accounting for 49% of the isolates; 81% of these were eradicated. There were 3 superinfections, all in the higher dosage group, one with Serratia liquifaciens which was resistant to CXM. CAE was generally well tolerated, with only 9 patients experiencing adverse events, most of which were gastrointestinal. None of these cases was sufficiently serious to require symptomatic treatment and in only one case was treatment stopped early. There was no difference in the incidence of side-effects in the two dosage groups. CAE, at a dose of 250 mg t.i.d. or 500 mg b.d., was demonstrated to be a safe and effective treatment for lower respiratory tract infections in the community.

Topics: Administration, Oral; Adolescent; Adult; Aged; Cefuroxime; Cephalosporins; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

A study was carried out in general practice to assess the clinical effectiveness and tolerability of the oral cephalosporin, cefuroxime axetil, in the treatment of 369 patients presenting with acute infections of the upper respiratory tract. The main diagnoses were tonsillitis, pharyngitis, sinusitis and otitis media. Patients were treated for 7 days with 1 tablet of 250 mg cefuroxime axetil twice daily. Details of fever and signs and symptoms of infection such as pain, sinus tenderness and reddening of the eardrum were recorded before and after treatment. Response was assessed by the physician on the basis of the clinical findings (the microbiological findings will be reported separately), and by patients on their satisfaction with their therapy. The results indicated an overall clinical improvement rate of 89%: all clinical parameters showed significant improvement and most patients were symptom-free when seen after treatment. Only 2 patients were classified as treatment failures and withdrawn from the study. Complete resolution of the infection was seen more often in patients with tonsillitis and pharyngitis than in those with sinusitis or otitis media. Over 80% of patients expressed their satisfaction with therapy. Adverse events reported were few, even though patients were prompted with a non-leading question, and were mainly mild in nature. The most frequently reported were diarrhoea (5%) and loose motions (3%).

Topics: Administration, Oral; Adult; Cefuroxime; Cephalosporins; Female; Follow-Up Studies; Humans; Male; Prodrugs; Respiratory Tract Infections