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Efficacy of a three day course of azithromycin in moderately severe community-acquired pneumonia
G Rizzato1, L Montemurro, P Fraioli
1Ente Ospedale Niguarda, Centro Thorax Divisione Medica Vergani e Servizio di Microbiologia, Milan, Italy.
Abstract:
This study was designed to evaluate the efficacy of a 3 day course of azithromycin in low to moderately severe community-acquired pneumonia. Forty patients with low to moderately severe community-acquired pneumonia (29 males, 11 females, mean age 46 +/- 17 yrs; 20 pretreated with betalactams for 2-10 days with no results before admission to hospital; 18 with evidence of co-morbidity) were enrolled in an open, randomized study with azithromycin, 500 mg q.d. oral therapy for 3 days, versus clarithromycin, 250 mg b.i.d. oral therapy for 10 +/- 2 days. The aetiology of pneumonia was identified in 18 patients by serology (nine Mycoplasma pneumoniae, four Chlamydia pneumoniae, five Legionella pneumophila; one patient with chlamydial infection also had Klebsiella pneumoniae bacteraemia). A presumptive aetiological diagnosis was obtained with sputum culture in three other patients (one Haemophilus influenzae, two Haemophilus parainfluenzae), all strains were sole isolates with 10(8) Colony forming units (CFU), and with Gram stain in one patient with Streptococcus pneumoniae. All patients in the azithromycin group (one after a second 3 day course), and all but two (of those available for evaluation) of the clarithromycin group were cured. Defervescence occurred after 2.6 +/- 1.6 days, and chest roentgenogram cleared after 8.9 +/- 3.3 days, with no difference between the two groups. Tolerance was good, and there were no withdrawals from therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
A 3-day course of azithromycin effectively treated community-acquired pneumonia, showing similar results to a 10-day clarithromycin regimen. This study highlights azithromycin
Area of Science:
- Infectious Diseases
- Pulmonology
- Pharmacology
Background:
- Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality.
- Effective antibiotic therapy is crucial for managing CAP.
- Optimizing treatment duration and efficacy is an ongoing area of research.
Purpose of the Study:
- To evaluate the efficacy of a short-course azithromycin regimen for community-acquired pneumonia.
- To compare azithromycin's effectiveness against clarithromycin in CAP treatment.
Main Methods:
- An open, randomized study involving 40 patients with low to moderately severe CAP.
- Azithromycin (500 mg once daily for 3 days) was compared to clarithromycin (250 mg twice daily for 10 days).
- Etiological diagnosis was pursued through serology and sputum cultures.
Main Results:
- High cure rates were observed in both treatment groups: all patients in the azithromycin group and all but two in the clarithromycin group were cured.
- Defervescence occurred at 2.6 +/- 1.6 days and chest X-ray clearance at 8.9 +/- 3.3 days, with no significant difference between groups.
- Both azithromycin and clarithromycin demonstrated good tolerance with no therapy withdrawals.
Conclusions:
- A 3-day course of azithromycin is an effective treatment for low to moderately severe community-acquired pneumonia.
- Short-course azithromycin offers a comparable efficacy to longer-duration clarithromycin therapy.
- Azithromycin presents a well-tolerated and potentially more convenient option for CAP management.