Forty outpatients with
sinusitis were treated with equimolar doses of
Ampicillin (556 mg) of
Bacampicillin (800 mg) three times daily in a doubleblind fashion. To control the efficiency of the
therapy the number of leukocytes, sedimentation rate, subjective and objective symptomes were evaluated before the first dose and on the 2nd and 10th day. On the 1st day nasal secretions were collected at the time the first dose was given and 1, 2, and 3 h later. In these samples the concentrations of the
antibiotic, of
protein and
albumin were determined. The amount of nasal secretions collected as well as the
protein and
albumin content remains fairly constant during the experiment. The concentration of
Bacampicillin in nasal secretions reaches its maximum of 0.92 microgram/ml 1 h after the application whereas with
Ampicillin it is 0.59 microgram/ml after 2 h. These values correspond to the concentrations which were found in normal test persons. The clinical result of the
therapy is slightly better with
Bacampicillin only if patients with severe
sinusitis were taken into account. In the patients with moderate or slight symptoms no difference was found. Two of the patients which were treated with
Ampicillin had to stop the
therapy because of severe diarrhoe. When using
Bacampicillin no patients had diarrhoe. This study shows that
Bacampicillin (as an inactive
ester of
Ampicillin) is resorbed quicker and gives higher concentrations in the nasal secretions. Thus, the
therapeutic effect is better in severe cases as compared to
Ampicillin. Moreover, the side effects are less.