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Rodolfo T. Rafael,MD.


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Short-course Levofloxacin (Levox, Floxel) for the treatment of acute bacterial sinusitis


Clinical Question:
In patient with acute bacterial sinusitis, is short course of Levofloxacin (LEVOX) safe and effective?

Bottom Line:
Levofloxacin 750 mg for 5 days is noninferior to levofloxacin 500 mg for 10 days. SIGNIFICANCE: Levofloxacin 750 mg for 5 days represents a safe and effective treatment regimen for acute bacterial sinusitis. EBM rating: A-1b.

Reference:
A trial of high-dose, short-course levofloxacin for the treatment of acute bacterial sinusitis.Poole M, Anon J, Paglia M, Xiang J, Khashab M, Kahn J. Otolaryngol Head Neck Surg. 2006 Jan;134(1):10-7.

Study Design:
Randomized Controlled Trial (multicenter)

Synopsis:
Compare two dosage strengths of levofloxacin in the treatment of acute bacterial sinusitis. Multicenter clinical trial comparing levofloxacin 750 mg for 5 days vs levofloxacin 500 mg for 10 days. Sinus fluid samples were obtained by antral puncture (59.2%) or by sinus endoscopy (40.8%). Among microbiologically evaluable patients, 91.4% (139/152) of patients receiving levofloxacin 750 mg achieved clinical success vs 88.6% (132/149) of patients receiving levofloxacin 500 mg (95% CI -10.0, 4.2). Clinical success rates by pathogen were above 90% in both treatment groups for the 3 typical pathogens of acute sinusitis: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The safety profile of the 2 dosage strengths was similar.

 

 

   

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