***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In this double-blind , parallel-group , multicenter study , 169 patients with symptoms of maxillary sinusitis but without radiographically confirmed empyema ( pus ) were r and omly assigned to receive either 500 mg azithromycin once daily for 3 days ( 87 patients ) or placebo daily for 3 days ( 82 patients ) . Nasal secretion , maxillary tenderness and pain , nasal obstruction , general malaise , and hyposmia were assessed at the start of the study and on days 4 , 11 , and 25 of treatment . After 11 days 58 % of the patients in the azithromycin group were cured versus 31 % in the placebo group ; after 25 days the cure rate was 79 % versus 67 % , respectively . When both cure and improvement were considered , the corresponding figures after day 25 were 90 % and 88 % , respectively . Adverse events , predominantly gastrointestinal , occurred in 24 ( 27 % ) of the azithromycin-treated patients and in 15 ( 18 % ) of those treated with placebo , but the difference was not statistically significant . There was a difference in efficacy in favor of azithromycin in the treatment of rhinitis with symptoms of maxillary sinusitis but without radiological signs of empyema ( pus ) . Antibiotics should only be used to alleviate symptoms in patients with moderate to severe symptoms , as the results after 25 days for both improvement and cure are equal . In the treatment of acute rhinitis with symptoms and signs of maxillary sinusitis but without empyema , treatment with azithromycin seems to result in a better cure rate after 10–12 days when compared with placebo OBJECTIVE To compare the efficacy of amoxicillin vs placebo in patients with an acute upper respiratory tract infection and purulent rhinorrhea . STUDY DESIGN Double-blind r and omized placebo-controlled trial . POPULATION The 416 patients included from 69 family practice s were 12 years or older , presenting with acute upper respiratory complaints , and having a history of purulent rhinorrhea and no signs of complications of sinusitis . OUTCOMES MEASURED Therapy success ( disappearance of symptoms that most greatly affected the patient 's health ) at day 10 and duration of general illness , pain , and purulent rhinorrhea . RESULTS Therapy was successful in 35 % of patients with amoxicillin and in 29 % of patients with placebo ( relative risk [ RR ] 1.14 , 95 % confidence interval [ CI ] , 0.92 - 1.42 ) . There was no effect on duration of general illness or pain . Duration of purulent rhinorrhea was shortened by amoxicillin ( 9 days vs 14 for clearing of purulent rhinorrhea in 75 % of patients ; P = .007 ) . Diarrhea was more frequent with amoxicillin ( 29 % vs 19 % , RR 1.28 , 95 % CI , 1.05 - 1.57 ) . No complications were reported . One patient ( 0.5 % ) receiving amoxicillin and 7 ( 3.4 % ) receiving placebo discontinued trial therapy because of exacerbation of symptoms ( RR 0.25 , 95 % CI 0.04 - 1.56 , P = .07 ) . All 8 patients recovered with antibiotic therapy . CONCLUSIONS Amoxicillin has a beneficial effect on purulent rhinorrhea caused by an acute infection of the nose or sinuses but not on general recovery . The practical implication is that all such patients , whatever the suspected diagnosis , can be safely treated with symptomatic therapy and instructed to return if symptoms worsen In this double-blind study of 60 infants with undifferentiated respiratory diseases , antibiotics seemed of no benefit in shorten ing the median duration of illness or in preventing secondary complications . The conclusion is drawn that the danger of complications from the antibiotics them selves is greater than the good which many physicians believe that antibiotics produce in such diseases preparation , and phenylephrine plus nitrofurazone 0.02 per cent solution t as the test preparation . Each was dispensed in a plastic dropping container marked only with a code number ; neither patient nor physician knew to which group the patient had been assigned . All 100 patients ---541 in each group-were from a general practice in pediatrics and had purulent rhinitis . Each patient was provided A double-blind r and omized controlled trial of amoxycillin , co-trimoxazole , and placebo was conducted on 197 children presenting with presumed viral respiratory infections . Routine throat swabs were taken to exclude streptococcal diseases . The three disease categories studied -- nasopharyngitis , pharyngotonsillitis , and bronchitis ( including laryngotracheobronchitis)--showed a generally similar pattern of resolution irrespective of treatment . Nevertheless , seven out of 66 children receiving placebo were withdrawn from the trial with unremitting symptoms or complications thought to require antimicrobial treatment . Only two of 56 children receiving amoxycillin and none of 75 receiving co-trimoxazole were withdrawn . Three other children receiving amoxycillin and three receiving placebo were seen during the trial but further treatment was not thought to be necessary . Thus the return consultation rate in children receiving placebo therapy was 15 % compared with 4 % for those receiving antimicrobial treatment . Antimicrobial treatment was associated with less nasal discharge on the eighth day of treatment . Placebo treatment allowed an earlier return to normal activity . There was a high incidence of possible side effects on all regimens including placebo . It is concluded that the benefits of antimicrobial treatment in presumed viral respiratory infections are marginal , and they should not be routinely prescribed for these conditions Purulent  nasal discharge  ( discharge that is thick , opaque and colored ) is a common clinical symptom in pediatrie patients . Although it may occur at any age it is probably most problematic and most common in children between birth and 2 to 3 years of age . This article review s the differential diagnosis , evaluation and management of purulent nasal discharge in children The benefits of antibiotic treatment and a nasopharyngeal culture in children with longst and ing cough were analysed in a prospect i ve r and omized open study . Clinical ly suspected pertussis was excluded . Of 40 children given erythromycin for 7 days , 35 ( 88 % ) recovered in one week , compared with 17/47 ( 36 % ) untreated ( p < 0.0001 ) . Erythromycin  eliminated Moraxella catarrhalis from the nasopharynx in 21/31 children ( 68 % ) , compared with spontaneous disappearance in 7/35 ( 20 % ) untreated controls ( p < 0.001 ) . Purulent bronchitis or otitis media occurred in 2 children ( 5 % ) in the treatment group and in 21 ( 45 % ) in the control group ( p < 0.01 ) . To evaluate the clinical role of isolated pathogens , the 47 untreated subjects were studied . Seven of 35 children harbouring M. catarrhalis recovered , compared with 8/12 in whom this bacterium was absent ( p < 0.01 ) . No correlation was found between the isolation of Haemophilus influenzae or Streptococcus pneumoniae and the clinical outcome .  Children with persistent cough  > 10 days may benefit from erythromycin treatment . M. catarrhalis in the nasopharynx indicates prolonged symptoms and increased risk of bacterial complications Effectiveness and clinical tolerance of the tixocortol-neomycin combination ( Pivalone-Neomycin nasal suspension ) used as monotherapy were evaluated in a double-blind placebo-controlled study ( placebo : vehicle i.e. , N-cetylpyridinium chloride , sodium chloride , sodium hydroxide solution , benzyl alcohol , purified water , monosodium phosphate ) in 211 pediatric patients ( aged 6 months to 8 years ) with uncomplicated acute rhinopharyngitis . After seven days therapy , improvement in symptoms of acute rhinopharyngitis , especially rhinorrhea and nocturnal cough , was greater in the tixocortol-neomycin group . Physical evaluation documented significant improvements in local superinfection with disappearance of mucopurulent nasal secretions and posterior drip . Locoregional outcome , evaluated on severity of infectious complications and antibiotic use , was also more favorable in the tixocortol-neomycin group . These results , together with the good clinical tolerance of the study drug , demonstrate the value of single-drug therapy with this local corticosteroid-neomycin combination in children with uncomplicated acute rhinopharyngitis . They confirm that local administration of corticosteroids to combat inflammatory phenomena is useful not only in the well-recognized lower respiratory tract indications ( asthma , respiratory syncitial virus infections ) but also in nasal diseases ( rhinitis ) AIM To assess General Practice ( GP ) description and management of upper respiratory tract infections ( URTI ) , including conditions under which they prescribe antibiotics . METHOD A telephone survey of a r and omised sample of Auckl and GPs . RESULTS There was a 61 % response rate . 82 of the 100 GPs interviewed agreed that most patients presenting with URTI expected antibiotics .  Persistent symptoms and indication of specific infection ( tonsillitis , otitis media , sinusitis , pharyngitis , purulent sputum ) were common reasons for prescribing . Patients travelling overseas , expecting or requesting antibiotics and prior use of over-the-counter ( OTC ) medications increased  antibiotic  prescribing-rates . Most GPs ( 95 % ) issued as-needed prescriptions on occasion ; 13 % did this often .  Amoxicillin and amoxicillin/clavulanic acid  were most commonly used . Despite wide-ranging antibiotic use for URTI ( 0 to 90 % ) , only 6 % of GPs felt they prescribed more  antibiotics  than others . CONCLUSIONS The results suggest over-prescription is common-place , but use of as-needed prescriptions to reduce antibiotic use is encouraging . Exploration of patient expectations in the consultation may assist in decreasing prescribing rates The clinical responses of children with upper respiratory infections to 1 of 3 treatment regimens ( tetracycline , penicillin , and placebo ) were evaluated in relation to the bacterial and viral pathogens cultured from nasopharyngeal swabs . The 3 treatment groups were similar in size and in the frequency and type of pathogens recovered . The groups did not differ in their response to the treatment regimens in terms of mean duration of fever , failure to improve , the development of complications , or the persistance of bacterial pathogens in the nasopharynx This preliminary study evaluated the effectiveness of enteric-coated erythromycin in the treatment of adults with nonstreptococcal pharyngitis . Twenty-six patients , aged 12 or older , with nonstreptococcal pharyngitis were r and omly assigned in a double-blind fashion to receive either enteric-coated erythromycin or placebo for 10 days . Each day the patients rated the soreness of their throats and how sick they felt . The use of erythromycin appeared to decrease the median number of days for the feeling of sickness to improve ( two days versus four days , P less than .01 ) as well as to decrease the median number of days for the feeling of sickness to resolve ( three- and -a-half days versus five days , P less than .05 ) . This apparent improvement in sickness occurred even though there was no significant decrease in the soreness of the throat in patients treated with erythromycin compared to those patients treated with placebo . Treatment with enteric-coated erythromycin appeared to shorten the time until improvement in this group of adults with nonstreptococcal pharyngitis Abstract The recommended treatment for mild acute respiratory infections ( ARI ) in children is supportive care only , but many physicians , especially in developing countries , continue to prescribe antibiotic treatment because they believe it prevents progression to more severe ARI . To find out whether ampicillin treatment conferred any benefit over supportive care alone , a r and omised , controlled trial was carried out among 889 children ( under 5 years ) with mild ARI in Indonesia . 447 were r and omly allocated  ampicillin ( 25 - 30 mg/kg body weight three times daily for 5 days ) plus supportive care ( continued breastfeeding , clearing of the nose , and paracetamol to control fever ) ; 442 were allocated supportive care only . The treatment groups were almost identical after r and omisation in terms of age , sex , level of parental education , history of measles immunisation , and fever . After 1 week the percentages cured were nearly identical ( 204 [ 46 % ] ampicillin ; 209 [ 47 % ] control ) , as were the percentages of cases progressing to moderate ARI ( 56 [ 13 % ] vs 53 [ 12 % ] ) . The effect of treatment was not modified by age , sex , measles immunisation status , or the educational level of the parents . At the 2-week follow-up , the percentages cured were 62 % ( 277 ) in the ampicillin group and 58 % ( 256 ) in the control group ; 14 % of both groups had progressed to moderate 
    Output:
    
There is no evidence of benefit from antibiotics for the common cold or for persisting acute purulent rhinitis in children or adults .
There is evidence that antibiotics cause significant adverse effects in adults when given for the common cold and in all ages when given for acute purulent rhinitis .