Tehran University Medical Journal

---

The purpose of this paper is to provides general information about avian influenza (bird flu) and specific information about one type of bird flu, called avian influenza A (H5N1), that has caused infections in birds in Asia and Europe and in human in Asia. The main materials in this report are based on the World Health Organization (WHO) , world organization for animal health (OIE) , food and agriculture organization of the united nations (FAO) information and recommendations and review of the published literature about avian influenza. Since December 2003, highly pathogenic H5N1 avian influenza viruses have swept through poultry populations across Asia and parts of Europe. The outbreaks are historically unprecedented in scale and geographical spread. Their economic impact on the agricultural sector of the affected countries has been large. Human cases, with an overall fatality rate around 50%, have also been reported and almost all human infections can be linked to contact with infected poultry. Influenza viruses are genetically unstable and their behaviour cannot be predicted so the risk of further human cases persists. The human health implications have now gained importance, both for illness and fatalities that have occurred following natural infection with avian viruses, and for the potential of generating a re-assortant virus that could give rise to the next human influenza pandemic.

---

Background: Acute bacterial sinusitis is one of the most common causes for antibacterial treatment. Oral Penbactam (ampicillin- sulbactum or Sultamicillin) is a broad spectrum antibiotic and it has no significant side effect. To our knowledge, this is the first study in Iran in which, oral Penbactam has been prescribed for patients with acute bacterial sinusitis.

Methods: A randomized clinical trial was performed on 44 outpatients diagnosed with acute bacterial sinusitis in Amir- Aalam Hospital from March 2003-2004 to August 2004. Patients were randomized in 2 group: 23 to oral Penbactam (375 mg twice daily), and 21 to oral Co-amoxicolav (625 mg three times daily). Duration of treatment was 10 days for both groups.

Results: Both groups showed a significant clinical improvement after 10 days of treatment. In the Penbactam group, 19 of 23 (86.36%) and in the Co-amoxicolav group ,18 of 21 (85.71%) showed clinical improvement. In the Penbactam group, one patient (4.3 %) developed diarrhea and the medication was discontinued.

Conclusion: Oral Penbactam is an effective and safe antibiotic in the treatment of acute bacterial sinusitis and could be used as an alternative medication for acute bacterial sinusitis.