Small CB, Jackson L, Sutter A, Pearl M, Deeter R; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1998 Sep 24-27; 38: 405 (abstract no. I-136).

Montefiore Medical Center, Bronx, NY.

Sinusitis is a major cause of morbidity in HIV infection. We reported that treatment (Rx) of sinusitis in HIV with intranasal steroids and antibiotics leads to faster resolution of SS and less Rx failures compared to antibiotics alone. The purpose of this blinded prospective study was to determine if a short (7d) course of antibiotics is equal to 14d when given with intranasal steroids in HIV+ pts with acute sinusitis 8 <3 episodes/2 yrs. Pts were randomly assigned to receive 21d Flonase (Fl)/Ceftin (7d) vs 21d Fl/Ceftin (14d). CD4 cells, viral load (VL), sinus x-rays 8 sinusitis severity score were measured. Follow-up was 6-16 weeks. Preliminary results on 28/70 pts include: 20 M & 8 F; mean age: 42 yrs; 16 Hisp,11 Bl,1 W. HIV risk: sex transmission: 19; IDU: 9.9 AIDS; 5 HIV+ symptomatic; 14 HIV+ asymptomatic. 13(46%) had Bactrim prophylaxis; 16 (57%) snorted heroin/cocaine; 16 (57%) used ETOH. 8 (29%) had asthma; 9 had allergies. 15 (89%) smoked cigarettes. Mean CD4: 354 cells/mm3; VL: 42,918 copies/ml. 16 received 7d Ceftin/FI; 12 received 14d Ceftin/FI. There were no differences in the 2 gps, but the VL was increased in the 14d gp (p<.05). Common symptoms were: nasal congestion (28); speech fullness (28); purulent nasal discharge (26); cough (22). The sinusitis severity score improved in both groups after 2 weeks (delta7d Ceftin = 18 vs delta14 d Ceftin = 16; p=NS). Cure/improvement (clinical and X-ray) occurred in 94% of the 7d Ceftin/FI vs 92% of 14d Ceftin/FI gps. There was 1 failure in each gp; 2 recurrences in the 7d 8 1 in the 14d gp. Side effects: Ceftin (nausea: 4), Fl (nasal bleeding: 2). Rx of sinusitis in HIV+ pts without chronic sinusitis with 7d Ceftin/FI is equivalent to 14d Ceftin/FI. Short course Rx will lead to decreased costs and side effects. Sinusitis occurs in HIV+ pts on Bactrim prophylaxis (46%).

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Anti-Bacterial Agents
• Antigens, CD4
• CD4-Positive T-Lymphocytes
• Cefuroxime
• HIV Infections
• HIV Seropositivity
• Humans
• Prospective Studies
• Rhinitis
• Sinusitis
• Sjogren's Syndrome
• Trimethoprim-Sulfamethoxazole Combination
• Viral Load
• cefuroxime axetil
• immunology
• therapy
• transmission

Other ID:

• 20710940

UI: 102188285

From Meeting Abstracts