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[Macrolides in the treatment of children with Mediterranean spotted fever]

Antonio Cascio1, Claudia Colomba

  • 1Istituto di Patoligia Infettiva e Virologia, Universita degli Studi di Palermo, Italy.

Le Infezioni in Medicina
|April 22, 2003
PubMed

Insights

Clarithromycin and azithromycin offer effective alternatives for treating Mediterranean spotted fever (MSF) in children, showing comparable or faster symptom resolution than traditional antibiotics like chloramphenicol.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Pharmacology

Background:

  • Mediterranean spotted fever (MSF) lacks a definitive gold standard treatment in pediatric populations.
  • Current standard therapies, tetracycline and chloramphenicol, carry significant risks for children, including dental staining and severe hematological adverse events.

Purpose of the Study:

  • To evaluate the efficacy of clarithromycin and azithromycin as alternatives for pediatric MSF treatment.
  • To compare the time to defervescence for clarithromycin versus chloramphenicol and clarithromycin versus azithromycin.

Main Methods:

  • Two randomized clinical trials were conducted.
  • Trial 1: Clarithromycin vs. Chloramphenicol for pediatric MSF.
  • Trial 2: Clarithromycin vs. Azithromycin for pediatric MSF.

Main Results:

  • Clarithromycin demonstrated a statistically significant shorter mean time to defervescence compared to chloramphenicol (36.7h vs 47.1h, P=0.047).
  • No significant difference in time to defervescence was observed between clarithromycin and azithromycin (46.2h vs 39.3h, P=0.34).

Conclusions:

  • Clarithromycin and azithromycin represent viable alternatives to tetracycline and chloramphenicol for treating MSF in children.
  • These macrolide antibiotics may offer a safer therapeutic profile compared to established treatments.

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