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Purpose: This study compared treatment failure during a 30 day period after initiation of the second line antibiotics cefuroxime or cefpodoxime in acute sinusitis patients seen in primary care offices. Treatment failure was defined as an antibiotic change or healthcare visit for additional treatment during the study period.
Methods: The practice management system records of a large multi-site primary care practice was searched to identify patients with an office visit for acute sinusitis who, based on claims data, were treated with cefpodoxime or cefuroxime. Hard copy patient charts along with electronic pharmacy and medical claims were searched for data collection.
Results: A cohort of 104 patients was identified, with 52 patients receiving each treatment. There was no difference in mean age, gender or patients > 18 between groups. Both groups were composed of 70% adult patients. There was no statistically significant difference found in the number of chronic sinusitis patients with an acute sinusitis exacerbation in the groups. There was no statistically significant difference in the presence of risk factors (recent viral rhinosinusitis, asthma, anatomical abnormalities, allergic rhinitis, immunosuppression, nasal intubation or packing, tooth abscess, swimming in contaminated water, and cigarette smoking) between groups. There was no difference in treatment failure at 30 days between groups. No statistically significant difference was found when acute sinusitis patients and chronic sinusitis patients were examined separately. There was no phone follow-up, so it is possible that patients could have paid for treatment at a retail clinic or acute care center. However it was felt that by reviewing the medical chart and insurance claims, visits to one of these clinics would have been identified.
Conclusion: No difference was found in treatment failure during a 30 day period after initiation of cefuroxime or cefpodoxime in treating acute sinusitis patients.