PRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 1 January 2006
Clinical Efficacy of 200 mg Twice Daily Administration
of Levofloxacin in the Treatment of Sinusitis
Sachio Takeno, Katsuhiro Hirakawa, Koji Yajin, Takashi Ishino and Tomoyuki Ogawa (Hiroshima University)
Hiroshi Watanabe and Hideto Okazaki (Hiroshima City Asa Citizens Hospital)
Hiroyuki Takahashi and Tohru Handa (Kure Kyosai Hospital)
Takashi Moliya (Hiroshima Kinen Hospital)
Makoto Sirane and Tsutomu Ueda (National Hospital Organization Kure Medical Center)
Akira Nagasawa and Naoki Hayashi (Miyoshi Central Hospital)
Yoshinori Kanemi (Saiseikai Kure Hospital)
Kunihiko Ono (Shobara Red Cross Hospital)
Haruo Hirakawa (Chugoku Rousai Hospital)
Mamoru Fujii (Chuden Hospital)
Yukinori Ohta and Nobuyuki Miyake (Mazda Hospital)
Kentaro Imon (JA Yoshida General Hospital)
Shitau Hirata and Kazushi Mizuno (JA Hiroshima General Hospital)
Fluoroquinolones, such as levofloxacin (LVFX), exert antibacterial effects in a dose-dependent manner and show a postantibiotic effect (PAE) that inhibits the growth of microorganisms after brief contact with the agent. In the present study, we prospectively evaluated whether the mode of administration influences the clinical efficacy of oral LVFX for infectious sinusitis. One hundred seven sinusitis patients were randomly divided into two groups (Group A (n=50): 200 mg twice a day, Group B (n=57); 100 mg three times a day). Both groups were treated with oral LVFX for 5-10 days then the clinical effectiveness and radiological improvement were evaluated. After treatment, 46.7% of patients in Group A and 65.1% of patients in Group B showed a clinical response, with the complete resolution rate being more pronounced in the latter group. Radiological improvement was observed in 42.0% of patients in Group A and 46.2% of patients in Group B. However, the difference was not significant. Treatment with oral LVFX proved efficacious for bacterial sinusitis, either acute or acute exacerbation. Our results also indicated that administering 200 mg twice a day is an effective and applicable alternative to obtain better clinical and bacteriological efficacy based on the theoretical pharmacodynamics.
Key words : bacterial sinusitis, levofloxacin, clinical efficacy, postantibiotic effect