An open, randomized comparative parallel study of the efficacy of Spiramycin (500 mg or 1.5 m IU per tablet) 2 tablets twice daily and Amoxycillin (500 mg per capsule) 1 capsule thrice daily for 7 days was performed in adult patients with acute community-acquired upper respiratory tract infections. In 45 patients treated with Spiramycin, 40 were classified by the investigators as “success” (=89%) compared to 48 patients in the amoxicillin group where 40 patients were classified as “success” (=83.3%).  Bacteriological cure was reported in 6/7 in spiramycin and in ¾ of the amoxicillin treated group.  Adverse drug reactions were reported in two patients in the spiramycin group and in one patient in the amoxicillin group.  These were classified as “mild” reactions.  There was no statistical significant difference of the success rates between the two treatment groups and between each type of URI i.e. acute rhinitis, acute pharyngitis, acute rhinopharyngitis, acute tonsillitis, acute sinusitis, and acute laryngitis.  It was concluded that spiramycin was as effective as amoxicillin in the treatment of acute URI.  The tolerance of both drugs was also similar.  The convenient twice daily dosage of spiramycin may allow better compliance of the patients.