Clarithromycin in the treatment of community-acquired lower respiratory tract infections

Clarithromycin is a macrolide with in-vitro activity against the organisms usually responsible for community-acquired pneumonia and acute exacerbations of chronic bronchitis. Three double-blind controlled studies each in pneumonia and chronic bronchitis are reviewed. In pneumonia clarithromycin is as effective as erythromycin and in acute-on-chronic bronchitis is as effective as ampicillin. In an open study of 46 patients with pneumonia due to Legionella pneumophila, resolution occurred in 93% with no deaths. The incidence of adverse events was 20% in 3437 patients. These were rarely severe. Clarithromycin is better tolerated than erythromycin and its twice daily dosage is likely to lead to better patient compliance.