Clarithromycin versus azithromycin in the treatment of Mediterranean spotted fever in children: a randomized

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Antonio Cascio1, Claudia Colomba, Spinello Antinori

  • 1Istituto di Patologia Infettiva e Virologia, Ospedale G. Di Cristina, Università di Palermo, 90134 Palermo, Italy. acascio@unime.it

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 12, 2001
PubMed

Insights

This study found that both clarithromycin and azithromycin are effective treatments for Mediterranean spotted fever in children. These antibiotics offer safe alternatives for treating this rickettsial disease.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Mediterranean spotted fever is a rickettsial disease in children lacking a gold-standard therapy.
  • Current treatment options like chloramphenicol and tetracyclines have limitations for pediatric use.

Purpose of the Study:

  • To compare the efficacy and safety of clarithromycin versus azithromycin for treating Mediterranean spotted fever in children.
  • To identify potential alternative antibiotic therapies for this pediatric rickettsial infection.

Main Methods:

  • An open-label randomized controlled trial involving 87 children diagnosed with Mediterranean spotted fever.
  • Participants were randomized to receive either clarithromycin (15 mg/kg/day in 2 doses for 7 days) or azithromycin (10 mg/kg/day in 1 dose for 3 days).
  • Efficacy was assessed by time to defervescence, and safety was evaluated through tolerability.

Main Results:

  • The mean time to defervescence was 46.2 ± 36.4 hours for clarithromycin and 39.3 ± 31.3 hours for azithromycin.
  • No statistically significant difference in the time to defervescence was observed between the two treatment groups.
  • Both clarithromycin and azithromycin were equally well-tolerated by the pediatric patients.

Conclusions:

  • Clarithromycin and azithromycin are acceptable therapeutic alternatives for children aged 8 years or younger with Mediterranean spotted fever.
  • Azithromycin's single daily dose and shorter treatment duration may improve patient compliance.
  • These macrolides offer safer alternatives to chloramphenicol and tetracyclines in pediatric cases.

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