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A comparative efficacy and safety study of clarithromycin, roxithromycin and erythromycin stearate in mild pneumonia
1Trakya University, Chest Medicine Department, Edirne-Turkey. gogus@trakya.edu.tr
Abstract:
The efficacy and safety of clarithromycin, roxithromycin and erythromycin stearate in mild pneumonia were compared in an open randomized trial. Eighty-six male patients, doing their obligatory military service, ranging between 19 and 24 years of age (mean 20), were randomly treated: 29 with clarithromycin 500 mg 12-hourly, 30 with roxithromycin 150 mg 12-hourly, and 27 with erythromycin stearate 500 mg 6-hourly, each course being administered for 10 days. Seventy-eight patients were able to be evaluated for efficacy, 28 receiving clarithromycin, 28 roxithromycin, and 22 erythromycin stearate. There were no significant differences among the groups in terms of clinical success rates (clinical cure or improvement: 89% for clarithromycin, 82% for roxithromycin, and 73% for erythromycin stearate, p = 0.32). However, we found that there were significant differences among the groups in terms of clinical cure rates (75% for clarithromycin, 64% for roxithromycin, and 41% for erythromycin stearate, p = 0.04). Adverse events, mostly gastrointestinal, caused discontinuation of treatment in 3.4% of the patients in the clarithromycin group, in 6.6% of the patients in the roxithromycin group, and in 18.5% of the patients in the erythromycin stearate group. The results indicate that there were no statistically significant differences among the three treatment groups in terms of clinical success rates, but that clarithromycin and roxithromycin were better tolerated.
Insights
This study compared three macrolide antibiotics for mild pneumonia. Clarithromycin and roxithromycin showed better clinical cure rates and tolerability than erythromycin stearate.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Mild pneumonia treatment requires effective and safe antibiotic options.
- Macrolide antibiotics are commonly used for respiratory tract infections.
- Comparative studies are essential to guide clinical practice.
Purpose of the Study:
- To compare the efficacy and safety of clarithromycin, roxithromycin, and erythromycin stearate in treating mild pneumonia.
- To evaluate clinical success and cure rates among the three antibiotic groups.
- To assess the tolerability and adverse event profiles of the studied antibiotics.
Main Methods:
- An open-label, randomized trial involving 86 male military service members aged 19-24.
- Patients were randomly assigned to receive clarithromycin (500 mg q12h), roxithromycin (150 mg q12h), or erythromycin stearate (500 mg q6h) for 10 days.
- Efficacy was evaluated in 78 patients, with clinical success and cure rates, and adverse events meticulously recorded.
Main Results:
- No significant differences were observed in overall clinical success rates (89% clarithromycin, 82% roxithromycin, 73% erythromycin stearate; p=0.32).
- Significant differences emerged in clinical cure rates, with clarithromycin (75%) and roxithromycin (64%) outperforming erythromycin stearate (41%; p=0.04).
- Adverse events, primarily gastrointestinal, led to treatment discontinuation in 3.4% (clarithromycin), 6.6% (roxithromycin), and 18.5% (erythromycin stearate) of patients, indicating better tolerability for clarithromycin and roxithromycin.
Conclusions:
- Clarithromycin and roxithromycin demonstrate superior clinical cure rates compared to erythromycin stearate in mild pneumonia.
- Clarithromycin and roxithromycin are better tolerated, with significantly lower rates of treatment discontinuation due to adverse events.
- These findings suggest clarithromycin and roxithromycin as favorable therapeutic options for mild pneumonia, considering both efficacy and safety profiles.