***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 the treatment of acute maxillary sinusitis , azithromycin offers an advantage over phenoxymethylpenicillin in that a complete course of treatment requires drug administration once daily for only three days . In this double-blind , parallel-group , multicenter study , 438 patients with radiographically verified maxillary sinusitis were r and omly assigned to receive either 500 mg azithromycin once daily for three days ( 221 patients ) or 1.3 g phenoxymethylpenicillin three times daily for ten days ( 217 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 51 % in the penicillin group ; after 25 days the cure rate was 79 % versus 76 % , respectively . When both cure and improvement were considered , the corresponding figures after 11 days were 97 % ( azithromycin ) and 95 % ( penicillin ) ; after 25 days they were 92 % and 88 % , respectively . Adverse events , predominantly gastrointestinal , occurred in 73 ( 33 % ) of the azithromycin-treated patients and in 87 ( 40.1 % ) of those treated with penicillin . No difference in efficacy was found between the two drugs in the treatment of acute maxillary sinusitis , and the adverse effects were comparable . The short duration of treatment with azithromycin offers a significant advantage over treatment with phenoxymethylpenicillin The clinical effect and the penetration of ampicillin into sinus secretion after oral administration of bacampicillin was studied in 47 patients with acute maxillary sinusitis allocated at r and om in treatment with 400 mg bacampicillin 3 times or 1200 mg twice daily . The overall clinical effect was similar and was assessed as " good " in 23/25 patients treated with 400 mg doses and in 19/22 treated with 1200 mg . Adverse reactions were reported by 4 patients . The concentrations of ampicillin obtained in sinus secretion were proportional to the dose given . The highest values after 400 mg bacampicillin were approximately 0.6 mg/l and after 1200 mg about 2 mg/l . Both dosages are applicable to treatment of acute maxillary sinusitis Respiratory tract pathogens ( beta-haemolytic streptococci groups A , C and G , Haemophilus influenzae , Branhamella catarrhalis or pneumococci ) , were isolated from nasopharyngeal and /or throat swabs in 73/138 ( 53 % ) patients greater than 10 years of age with a clinical diagnosis of acute sinusitis , acute tonsillitis , purulent nasopharyngitis or acute bronchitis . Serological evidence of a viral infection ( influenza A and B , parainfluenza 1 , 2 and 3 , respiratory syncytial virus , adenovirus ) or Mycoplasma pneumoniae infection was found in 10 % of the patients . The serum content of C-reactive protein ( S-CRP ) was increased ( greater than 12 mg/l ) in 26/33 ( 79 % ) patients with streptococci and in 22/59 ( 37 % ) patients without respiratory tract bacteria . In patients with a serological evidence of a virus tonsillitis , the S-CRP was also high ( 32 - 64 mg/l ) . At follow-up 10 - 12 days after the first visit , the clinical effect of erythromycin and penicillin V was judged to be similar ( 90 % clinical effect ) . Relapse or re-infection with group A streptococci were seen in 7 patients ( 4 on erythromycin , 3 on penicillin ) . In another 6 patients ( 3 on erythromycin , 3 on penicillin ) , antibiotic treatment was switched owing to persisting symptoms , probably due to H. Influenzae infection in 3 cases . The patients ' own estimates of their symptoms suggested treatment with erythromycin to have a more rapid effect than treatment with penicillin PURPOSE To compare the efficacy and tolerability of a 3-day course of azithromycin with a 10-day course of amoxicillin/clavulanic acid in the treatment of acute sinusitis in adults . PATIENTS AND METHODS One hundred adult patients with acute sinusitis were included in an open , r and omized study . Clinical diagnosis of sinusitis was confirmed by nasal endoscopy , sinus radiography , and ( when possible ) by culture of sinus aspirate . Patients were r and omized to receive azithromycin ( 500 mg once daily for 3 days ) or amoxicillin/clavulanate ( 625 mg every 8 hours for 10 days ) . RESULTS A significantly faster resolution of signs and symptoms of sinusitis was observed in the azithromycin-treated patients . By the end of therapy ( days 10 - 12 ) , 95 % of the patients in the azithromycin group and 74 % in the amoxicillin/clavulanate group were cured . The remaining patients ' conditions were improved . By the follow-up visit , cure was achieved in 98 % of the azithromycin-treated patients , and 91 % of the amoxicillin/clavulanate-treated patients . Treatment failure was observed in three patients from the amoxicillin/clavulanate group , and relapse occurred in one patient from each group . Bacteriologic eradication was achieved in 23 of 23 and 21 of 24 patients treated with azithromycin and amoxicillin/clavulanate , respectively . Both drugs were well tolerated . Two patients ( 4 % ) from the azithromycin group and five patients ( 10 % ) from the amoxicillin/clavulanate group reported mild gastrointestinal disturbances . CONCLUSIONS In adults with acute sinusitis , a 3-day course of azithromycin was as effective and well tolerated as a 10-day course of amoxicillin/clavulanic acid . A significantly simpler dosage regimen and faster clinical effect were the advantages of azithromycin Loracarbef is an oral synthetic beta-lactam antibiotic in the new carbacephem class . We conducted a multicenter , r and omized , double-blind , parallel-group study to compare the efficacy and safety of loracarbef 200 mg twice daily ( BID ) and 400 mg BID when given orally for 10 days to patients 12 years of age and older with acute maxillary sinusitis . Because sinus aspirates for culture are not routinely obtained in the management of acute maxillary sinusitis , antimicrobial therapy usually is selected empirically . This study was design ed to provide data simulating the usual clinical practice of treatment without sinus aspiration . Two hundred nine patients who met the entry criteria , which included abnormal pretherapy sinus radiographs compatible with acute maxillary sinusitis and symptoms of fewer than 4 weeks ' duration , qualified for the clinical analyses . Of the 106 clinical ly qualified patients assigned to the 200-mg BID group , favorable clinical responses ( cure and improvement ) were noted in 86 ( 81.1 % ) patients . Of the 103 clinical ly qualified patients assigned to the 400-mg BID group , 84 ( 81.6 % ) patients had favorable clinical responses . These results compare favorably with accepted clinical response rates of 70 % to 80 % for beta-lactams selected on an empiric basis . At the end of the treatment period , favorable radiologic responses ( resolved and improved ) and favorable clinical responses occurred in 55 ( 51.9 % ) of the 106 clinical ly qualified patients in the 200-mg BID group and in 57 ( 55.3 % ) of the 103 clinical ly qualified patients in the 400-mg BID group . Mean roentgenogram scores for the clinical ly qualified patients were 2.3 for both groups before therapy and 1.3 and 1.5 after therapy for the 200-mg BID and 400-mg BID groups , respectively . The mean change from pretherapy to posttherapy by patient was 1.0 for the 200-mg BID group and 0.8 for the 400-mg BID group . There were no statistically significant differences between treatment groups in the incidence of specific adverse events reported during therapy . These data suggest that loracarbef 200 mg BID is comparable in efficacy and safety to loracarbef 400 mg BID in the treatment of patients with acute maxillary sinusitis The efficacy , tolerability and safety of azithromycin and co-amoxiclav in the treatment of non-severe acute maxillary/ethmoidal sinusitis  were compared in a r and omized , open clinical trial in 254 adult patients . The predominant pathogens were Streptococcus pneumoniae and Haemophilus influenzae ( 83 patients ) .  Azithromycin was administered orally to 165 patients at a single daily dose of 500 mg for 3 days , and co-amoxiclav ( 4:1 ) to 89 patients , at a dose of 500 mg three times daily for 10 days . The overall clinical response rates were 87.5 % for azithromycin and 83.7 % for co-amoxiclav at follow-up ( day 21–28 ) . Microbiological responses to both drugs were good , with only five patients in each group having a persistent infection after treatment . Both drugs were well tolerated and produced similar incidences of adverse events , which were mostly gastrointestinal .  Azithromycin was as effective , and as well tolerated as co-amoxiclav , and its shorter simpler dosing regime may offer advantages in compliance and cost In two ear , nose and throat ( ENT ) divisions , 74 patients affected by acute sinusitis of bacterial origin were selected and , after r and omization in two balanced groups following an open parallel group design , assigned to treatment with brodimorprim and roxithromycin . At the beginning , after 3 days , 7 days and at the end of treatment the following symptoms were evaluated , using a four-step score : intensity of facial pain , headache , nasal stiffness , hyposmia , nasal secretion . The mean treatment period was 8.7 days . Tolerability was evaluated through registration and analysis of side effects and laboratory blood tests . The comparison between groups showed a better activity of brodimoprim on facial pain , headache , nasal stiffness and nasal secretion . The presence of resistant bacterial strains was greater in the group treated with roxithromycin ( 30.8 % ) when compared with the brodimoprim group ( 12.5 % ) . Side effects were reported in 5 patients treated with brodimoprim and in 3 patients in the control group . Lab tests did not show serious variations BACKGROUND The treatment of acute , recurrent , and chronic sinusitis remains controversial because of the presence of a wide variety of aerobic and anaerobic bacteria in the sinuses . DESIGN This double-blind , r and omized trial compared cefaclor with amoxicillin in the treatment of acute , recurrent , and chronic maxillary sinusitis using clinical evaluation , roentgenography , and microbiologic evaluation of antral aspirates . SETTING Outpatient office of five otorhinolaryngologists in Salt Lake City , Utah . PATIENTS One hundred eight adult patients with acute , recurrent , or chronic maxillary sinusitis . INTERVENTION Oral treatment with cefaclor ( 500 mg ) twice daily or amoxicillin ( 500 mg ) three times daily for 10 days . MAIN OUTCOME MEASURE Clinical response to treatment with cefaclor vs amoxicillin . RESULTS Fifty-six patients with acute sinusitis , 25 with recurrent sinusitis , and 15 with chronic sinusitis were evaluable . Although multiple organisms were common in each group , patients with acute sinusitis were more likely to have Haemophilus influenzae or Streptococcus pneumoniae , and patients with recurrent or chronic sinusitis were more likely to have anaerobes in sinus aspirate . Whether treated with cefaclor or amoxicillin , clinical improvement occurred in 86 % of patients with acute sinusitis and 56 % of patients with recurrent sinusitis . Patients with chronic sinusitis were too few to allow statistical analysis of the differences in outcome between them and patients with recurrent or acute sinusitis . Resistance of the cultured organisms to the study drug used was unrelated to treatment outcome . CONCLUSIONS The rate of clinical improvement was high in patients with acute sinusitis but was less favorable in those with recurrent and chronic disease regardless of the study drug used . The susceptibility of organisms isolated to the study drugs was unrelated to outcome PURPOSE This multicenter study compared the clinical and bacteriologic efficacy of two oral antibiotics , cefuroxime axetil and amoxicillin/clavulanate , in the treatment of acute bacterial maxillary sinusitis . PATIENTS AND METHODS Three hundred seventeen patients with clinical and radiographic evidence of acute maxillary 
    Output:
    
Radiographic outcomes were improved by antibiotic treatment .
REVIEW ER 'S CONCLUSIONS For acute maxillary sinusitis confirmed radiographically or by aspiration , current evidence is limited but supports the use of penicillin or amoxicillin for 7 to 14 days .