Assessment of Clinical Antimicrobial Garenoxacin (GRNX) Efficacy Using Clinical Scoring in Adults with Acute Rhinosinusitis

Abstract

In a prospective study of rhinosinusitis treatment efficacy in 163 subjects at 30 medical facilities between 2008 and 2009, we studied isolation of three major pathogenic bacteria-Streptococcus pneumoniae, Haemophillus influenzae, and Moraxella catarrhalis. We also examined clinical garenoxacin (GRNX) efficacy in 106 acute rhinosinusitis cases and 57 acute chronic rhinosinusitis exacerbation cases using Japan Acute Rhinosinusitis Clinical Guideline 2010 clinical scoring. Isolation of S. pneumoniae was 50.0% (22/44), H. influenzae 43.2% (19/44), and M. catarrhalis 6.8% (3/44) in 106 acute rhinosinusitis subjects. Drug-resistant strains accounted for over 50% in S. pneumoniae and H. influenzae. Isolation of the three bacterial pathogens in 57 acute chronic rhinosinusitis exacerbation subjects was 50.0% (9/18) in S. pneumoniae, 27.8% (5/18) in H. influenzae, and 22.2% (4/18) in M. catarrhalis. Drug resistance exceeded 40% in S. pneumoniae and H. influenzae. In efficacy studies of 97 subjects, GRNX at 400 mg/day in 54 with acute rhinosinusitis was 100%—marked improvement in 51.9% (28/54) and moderate in 48.1% (26/54). Efficacy in 43 acute chronic rhinosinusitis exacerbation subjects was 95.3%—marked improvement in 79.1% (34/43) and moderate in 16.3% (7/43). These results show the usefulness of clinical scoring in diagnosing diseases severity and in studying the efficacy of antimicrobial agents. Data clearly indicated the high clinical and bacterial efficacy of garenoxacin in treating adult rhinosinusitis.