EFFICACY OF AZITHROMYCIN COMPRED WITH SPIRAMYCIN IN THE TREATMENT OF ODONTOGENIC INFECTIONS

Sixty patients with acute odontogenic infection were randomly allocated to oral treatment with azitromycin 500 mg/day once-daily for three days (n = 30) or spiramycin 3,000,000 units three-times daily for seven days (n = 30). Baseline and post-treatment oral specimens were collected from patients to test for pathogenic bacteria. Aerobic bacteria were tesrted using the Kirby-Bauer disc diffusion method, and anaerobic bacteria with a broth microdilution method for their susceptibility to azithromycin and spiramycin. A greater incidence of resistance was found in the spiramycin group than in the azithromycin group. THe bacteriological assessment showed that the normal balance of microflora was re-established in 67%of patients treated with azithromycin vs 53% in the group treated with spiramycin. Clinical cure was higher in the azithromycin treatment group (97%) compared with the spiramycin group (73%). These results indicae that three-day azithromycin, possibly because of its unusual pharmacokinetics, is more effective than seven-day spiramycin in the treatment of odontogenic infections.