Cefuroxime axetil is a
beta-lactamase-stable, second-generation, oral
cephalosporin that penetrates sinus tissue in concentrations exceeding the MIC90 values (the minimum concentration of
drug needed to inhibit the growth of 90% of an isolate of a particular microorganism) for pathogens most commonly associated with acute
sinusitis, including Streptococcus pneumoniae and Haemophilus influenzae. A review of all clinical data published to date demonstrates that
cefuroxime axetil has been evaluated in the treatment of acute
sinusitis and acute exacerbations of chronic
sinusitis ("acute-on-chronic
sinusitis") in 18 clinical trials involving 1516 assessable patients. In 12 randomized, comparative trials, the rates of satisfactory clinical outcomes (cure or improvement, 79% to 100%) and bacteriologic eradication (84% to 100%) reported with the use of 250 mg of
cefuroxime axetil twice daily were similar to those observed with the use of
amoxicillin,
amoxicillin/
clavulanate potassium,
cefaclor,
cefadroxil,
cefixime,
clarithromycin, and
doxycycline. In these comparisons, no
antibiotic demonstrated any therapeutic advantages over
cefuroxime axetil regarding time to symptom abatement.
Cefuroxime axetil was at least as well tolerated as the other
antibiotics. Overall, the role of
cefuroxime axetil in the treatment of
sinusitis appears to be as one of the broad-spectrum
antibiotics that can be used for
infections due to the most commonly implicated sinus pathogens, especially those due to the increasing number of relatively
penicillin-resistant strains of S pneumoniae and
beta-lactamase-producing strains of H influenzae and Moraxella catarrhalis.