Rev Esp Quimioter 2008;21(1):14-21

Efficacy of cefditoren in the treatment of upper respiratory tract infections: a pooled analysis of six clinical trials

J. J. Granizo ,  M. J. Giménez ,  J. Barberán ,  P. Coronel ,  M. Gimeno ,  L. Aguilar  

Objective. A pooled analysis of all upper respiratory tract infection studies performed with cefditoren (CDN) was performed.  

Methods. Studies were prospective, comparative, multicentre and randomised. Comparators were penicillin V (pharyngitis) and cefuroxime or amoxicillin/clavulanate (sinusitis). A total of 1,322 patients were randomized, 1,241 included in intention-to-treat (ITT) and 1,010 in per-protocol populations (PP) in pharyngotonsillitis studies, and 1,819 randomized, 1,726 included in ITT and 1,589 in PP in acute sinusitis studies. 

Results. No significant differences in pharyngitis clinical response were found (success rates: 89.4 % to 95.3 %). S. pyogenes eradication was higher with cefditoren at end of therapy (EOT) (90.4% vs. 82.7%; p=0.002) and follow-up (84.7% vs. 76.7%; p=0.008), although no statistically significant (p<0.001). In both groups, clinical failures were significantly higher (p<0.001) in patients showing S. pyogenes persistence than in those showing eradication (≥98.5% vs. 51.4 %). No differences in sinusitis clinical response were found between CDN and comparators both at EOT (80.2% vs. 84.8%) and at end of follow-up (71.2% vs. 77.4%).  

Conclusion. Cefditoren had similar point estimates of clinical efficacy to comparators in pharyngotonsillitis and sinusitis, and a tendency to higher S. pyogenes eradication in pharyngotonsillitis.   

Key words:Cefditoren. S. pyogenes. Clinical trial. Pooled analysis. Sinusitis. Pharyngotonsillitis.   

 

Rev Esp Quimioter 2008;21(1):14-21 [pdf] 

/por

Rev Esp Quimioter 2008;21(1):4-13

Behavior of the Primary Care physicians in the treatment of community infections

 A. Orero ,  A. Navarro ,  S. López ,  M. A. Ripoll ,  J. González ,  J. Prieto   

This study aimed to evaluate the behavior of the physicians who attend to patients with community infections who are responsible for most of the antibiotic prescriptions made in the community setting. Furthermore, the evolution over the last 10 years in regards to the treatment habits of the most frequent infections in Primary Health Care (PHC) was studied and prescription behaviors were analyzed in relationship to the acquaintance and attitude of the participating physicians. A data collection sheet from 1,411 prescriptions made by 855 physicians from different specialties was used to conduct the study. This represents a statistically significant sample nationwide both from the point of view of the physicians involved in the treatment of infectious diseases in PHC as well as regarding to the prescriptions they have written. The study reveals the amplitude of respiratory and pararespiratory disease with oral antimicrobial agents, particularly beta-lactamics, and the significant advance in the last 10 years in the use of amoxicillin and clavulanic acid as treatment of choice. Treatment duration was somewhat longer while the number of containers prescribed was less than in the previous study. This would be related to the use of more spaced doses of the antimicrobial agents. Furthermore, the study reveals some discrepancies between attitudes and events of the physicians in the approach to certain diagnoses. 

Key words:Behavior. Primary care physicians. Prescription. Antimicrobials agents.  

Rev Esp Quimioter 2008;21(1):4-13 [pdf] 

/por