Does amoxicillin improve outcomes in patients with purulent rhinorrhea? A pragmatic randomized double-blind controlled trial in family practice.

摘要: ■ 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 randomized placebo-controlled trial. POPULA TION The 416 included from 69 family practices were 12 years or older, presenting complaints, having a history rhinorrhea no signs complications sinusitis. OUTCOMES MEASURED Therapy success (disappearance symptoms that most greatly affected patient’s health) at day 10 duration general illness, pain, RESUL TS was successful 35% 29% (relative risk [RR] 1.14, 95% confidence interval [CI], 0.92-1.42). There effect on illness pain. Duration shortened by (9 days 14 for clearing 75% patients; P = .007). Diarrhea more frequent (29% 19%, RR 1.28, CI, 1.05-1.57). No reported. One patient (0.5%) receiving 7 (3.4%) discontinued trial therapy because exacerbation (RR 0.25, CI 0.04-1.56, .07). All 8 recovered antibiotic therapy. CONCLUSIONS Amoxicillin has beneficial caused nose sinuses but not recovery. practical implication is all such patients, whatever suspected diagnosis, can be safely treated symptomatic instructed to return if worsen. KEY WORDS Respiratory infections; sinusitis; antibiotics; therapeutics; practice. (J Fam Pract 2002; 51:317-323)