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. |