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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, STUDY DESIGN, POPULATION, OUTCOMES MEASURED, RESULTS. Meshes: Adult, Age Factors, Aged, Aged, 80 and over, Amoxicillin, Anti-Bacterial Agents, Bronchitis, Double-Blind Method, Family Practice, Female, Humans, Logistic Models, Male, Middle Aged, Netherlands, Odds Ratio, Penicillins, Pneumonia, Respiratory Tract Infections, Roxithromycin.
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Is roxithromycin better than amoxicillin in the treatment of acute lower respiratory tract infections in primary care? Context: To assess the efficacy of roxithromycin relative to amoxicillin. We conducted a double-blind randomized controlled trial of oral 500 mg amoxicillin 3 times per day vs oral 300 mg roxithromycin once a day for 10 days. We included 196 adults who had presented to a general practitioner with lower respiratory tract infection (LRTI) and, in the physician's opinion, needed antibiotic treatment. We measured clinical response after 10 and 28 days, defined in 4 ways: (1) decrease in LRTI symptoms; (2) complete absence of symptoms; (3) decrease in signs; and (4) complete absence of signs. Self-reported response included the decrease in symptoms and the time until resumption of impaired or abandoned daily activities on days 1 through 10, 21, and 27. Clinical cure rates after the completion of antibiotic treatment (10 days) were not significantly different for the 2 groups. After 28 days, the roxithromycin group showed no increase in cure rate as evidenced by the decrease in symptoms, indicating a significantly lower cure rate. However, this difference did not alter physicians' overall conclusion after complete follow-up that 90% of patients, regardless of age, had been effectively treated with either amoxicillin or roxithromycin.
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The surplus value of roxithromycin was not confirmed. Amoxicillin remains a reliable first-choice antibiotic in the treatment of LRTI in general practice.