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Azithromycin prophylaxis during a hospital outbreak of Mycoplasma pneumoniae pneumonia

T B Hyde1, M Gilbert, S B Schwartz

  • 1Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.

The Journal of Infectious Diseases
|March 10, 2001
PubMed

Insights

Azithromycin prophylaxis may reduce clinical illness during Mycoplasma pneumoniae outbreaks. This study found a 75% reduction in respiratory illness in healthcare workers receiving azithromycin compared to placebo.

Area of Science:

  • Infectious Diseases
  • Respiratory Medicine
  • Clinical Trials

Background:

  • Mycoplasma pneumoniae (MP) outbreaks in closed communities are common and prolonged.
  • Azithromycin chemoprophylaxis has not been previously studied for MP transmission control.

Purpose of the Study:

  • To evaluate the efficacy of azithromycin chemoprophylaxis in preventing clinical illness during an MP outbreak.
  • To assess the impact of azithromycin on MP transmission among asymptomatic hospital employees.

Main Methods:

  • A randomized, double-blinded, placebo-controlled trial involving 147 asymptomatic hospital employees.
  • MP detection via oropharyngeal swabs and polymerase chain reaction.
  • Clinical illness assessment through questionnaires.

Main Results:

  • Azithromycin prophylaxis demonstrated a 75% protective efficacy against clinically significant respiratory illness (95% CI, 28%-91%).
  • MP carriage rates were similar between the azithromycin and placebo groups at weeks 1 and 6.
  • Four respiratory illness episodes occurred in the azithromycin group versus 16 in the placebo group.

Conclusions:

  • Azithromycin prophylaxis may be a valuable strategy for reducing clinical illness during MP outbreaks in closed settings.
  • Prophylactic azithromycin appears effective in mitigating symptomatic MP infections without significantly altering carriage rates.

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