Flurithromycin versus clarithromycin in upper respiratory tract infections

The efficacy and tolerability of flurithromycin and clarithromycin in the treatment of bacterial upper respiratory tract infections were compared in a multicenter, parallel-group, double-masked, double-dummy study of 320 adult patients who mere randomized to two treatment groups. Flurithromycin was administered as one 375-mg tablet twice daily and clarithromycin as one 250-mg tablet twice daily for up to 14 days, In the flurithromycin group, 3 patients were lost to observation, 1 withdrew because of poor compliance and 1 because of diarrhea, and 2 were considered clinical failures at treatment completion, In the clarithromycin group, 2 patients withdrew for treatment inefficacy and 12 were considered clinical failures at treatment completion, All other patients were judged to be cured or improved, Thus the intent-to-treat success rates were 153 (95.6%) of 160 patients in the flurithromycin group and 146 (91.3%) of 160 patients in the clarithromycin group; the difference was not statistically significant; The eradication rate of the baseline pathogens, mostly gram-positive cocci, was 123 (90.4%) of 136 patients in the flurithromycin group and 126 (91.3%) of 138 patients in the clarithromycin group, Response rates did not vary appreciably by infection site or baseline pathogen, Adverse events, mostly mild-to-moderate gastrointestinal disturbances, were observed in 8 patients (5.0%) in the flurithromycin group and in 11 patients (6.9%) in the clarithromycin group. These results suggest that flurithromycin 375 mg twice daily is as effective and well tolerated as clarithromycin 250 mg twice daily in the treatment of upper respiratory tract infections.