Trial to Evaluate Time to Symptom Relief and Elimination of Infecting Bacteria in Treating Sinusitis With Avelox (SPEED)

• Patient-reported symptom improvement using SNOT-16 questionnaire [ Time Frame: Up to End of Treatment (Day 10-13) ] [ Designated as safety issue: No ]
• Clinical Response [ Time Frame: End of Treatment ] [ Designated as safety issue: Yes ]
• Bacteriological Response [ Time Frame: End of Treatment ] [ Designated as safety issue: No ]
• Activity Impairment Assessment questionnaire [ Time Frame: Up to End of Treatment (Day 10-13) ] [ Designated as safety issue: No ]
• Incidence of Premature Termination [ Time Frame: Premature Termination ] [ Designated as safety issue: Yes ]
• Adverse Events Collection [ Time Frame: Up to End of Treatment (Day 10-13) ] [ Designated as safety issue: Yes ]

• Patient-reported symptom improvement using SNOT-16 questionnaire [ Time Frame: Up to End of Treatment (Day 10-13) ] [ Designated as safety issue: No ]
• Clinical Response [ Time Frame: End of Treatment ] [ Designated as safety issue: Yes ]
• Bacteriological Response [ Time Frame: End of Treatment ] [ Designated as safety issue: No ]
• Activity Impairment Assessment questionnaire [ Time Frame: Up to End of Treatment (Day 10-13) ] [ Designated as safety issue: No ]
• Incidence of Premature Termination [ Time Frame: Premature Termination ] [ Designated as safety issue: Yes ]
• Adverse Events [ Time Frame: Up to End of Treatment (Day 10-13) ] [ Designated as safety issue: Yes ]

This study evaluated the time to bacteriological eradication of common pathogens during moxifloxacin therapy for acute bacterial maxillary sinusitis. The study also examined the time to resolution of key symptoms associated with sinusitis.

Inclusion Criteria:

• Clinical diagnosis of acute sinusitis with signs and symptoms present for >7 days but < 28 days as defined by A), radiographic, and B) clinical criteria, as follows:

  1. The presence of 1 or more of the following on a radiographic paranasal sinus film (Waters' view) or limited CT scan:

     • evidence of air-fluid levels
     • opacification

  2. The presence of at least one major and one minor symptom as defined in the list below:

     • Major Symptoms

       • Purulent anterior or posterior nasal discharge
       • Unilateral moderate or severe facial pain or malar tenderness

     • Minor Symptoms

       • Cough or frequent throat clearing
       • Frontal headache
       • Halitosis
       • Fever (oral > 38.0°C/100.4°F, tympanic > 38.5°C/101.2°F)
       • Purulent secretions obtained via middle meatus secretion sampling using nasal endoscopic technique; the specimen sent for Gram stain, culture and susceptibility testing prior to initiation of antimicrobial therapy

     Exclusion Criteria:

• History of chronic sinusitis defined as greater than four weeks of continuous symptoms (patients with history of sinus surgery may be included; patients with recurrent sinusitis may be included)
• Known bacteremia, meningitis or infection infiltrating the tissues neighboring the sinuses
• Received systemic antibacterial therapy likely to be effective in sinusitis for more than 24 hours within 7 days of enrollment
• A requirement for concomitant systemic antibacterial therapy with agents other than those specified in this protocol
• Known immunodeficiency diseases including AIDS (CD4 <200)
• On topical nasal or systemic corticosteroids, unless they have been on a stable dose for > 4 weeks prior to enrollment
• History of allergy to quinolone antibiotics or related compounds
• Pregnant or breast feeding
• Of childbearing potential in whom pregnancy cannot be excluded by a negative pregnancy test and who are not using reliable barrier method of contraception
• Received an investigational drug in the past 30 days
• Unable to take oral medication
• Known to have congenital or sporadic syndromes of QTc prolongation or receiving concomitant medication reported to increase the QTc interval (e.g. amiodarone, sotalol, disopyramide, quinidine, procainamide, terfenadine)
• End stage liver cirrhosis (class Child-Pugh C)
• Severe renal impairment requiring dialysis
• Previous history of tendinopathy associated with quinolones
• Any symptoms that suggest that the patient's current illness is allergic rhinitis (e.g., repetitive sneezing, itchy nose or eyes, provocation by an allergen) and not acute bacterial sinusitis
• Diagnosis of rapidly fatal illness with a life expectance of less than 6 months
• Previously enrolled in this clinical study
• Uncorrected hypokalaemia