Summary
An open comparative study was undertaken in order to assess the efficacy and safety of a single dose of azithromycin in the treatment of community-acquired atypical pneumonia. A total of 100 adult patients with atypical penumonia syndrome were randomized to receive 1.5 g of azithromycin as a single dose, or 500 mg once daily for 3 days. The presence ofMycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Coxiella burnetii, andLegionella pneumophila infection was diagnosed by serological tests. Control clinical examinations were performed 72h, 10–12 days and 4 weeks after treatment initiation. Among 96 patients (48 in each group) who were evaluable for clinical efficacyM. pneumoniae infection was confirmed in 24,C. pneumoniae in nine,C. psittaci in five,C. burnetii in six, andL. pneumophila in five. Forty-seven patients (97.9%) in each group were cured. Side effects were observed in two patients in the single-dose group, and one patient in the 3-day group. In conclusion, a single 1.5 g dose of azithromycin may be an alternative to the standard 3-day azithromycin regimen in the treatment of outpatients with atypical pneumonia syndrome.
Similar content being viewed by others
References
Levison, M. E.: Pneumonia, including necrotizing pulmonary infections (lung abscess). In:Isselbacher, K. J., Braunwald, E., Wilson, J. D., Martin, J. B., Fauci, A. S., Kasper, D. L. (eds.) Harrison's principles of internal medicine. McGraw-Hill, New York 1994, pp. 1184–1191.
Donowitz, G. R., Mandell, G. L.: Acute pneumonia. In:Mandell, G. L., Bennett, J. E., Dolin, R. (eds.), Mandell, Douglas and Bennett's principles and practice of infectious diseases. Churchill Livingstone, New York 1995, pp. 619–637.
Cunha, B. A., Ortega, A. M.: Atypical pneumonia Extrapulmonary clues guide the way to diagnosis. Postgrad. Med. 99 (1996) 123–132.
Hoepelman, I. M., Schneider, M. M. E.: Azithromycin: the first of the tissue-selective azalides. Int. J. Antimicrob. Agents 5 (1995) 145–167.
Renaudin, H., Bebear, C.: Comparativein vitro activity of azithromycin, clarithromycin, erythromycin and lomefloxacin againstMycoplasma pneumoniae, Mycoplasma hominis andUreaplasma urealyticum. Eur. J. Clin. Microbiol. Infect. Dis. 9 (1990) 838–841.
Felmingham, D., Robbins, M. J., Sanghrajka, M., Leakey, A., Ridgway, G. L.: Thein vitro activity of some 14-, 15- and 16-membered macrolides againstStaphylococcus spp.,Legionella spp.,Mycoplasma spp. andUreaplasma urealyticum. Drugs Exp. Clin. Res. 17 (1991) 91–99.
Ishida, K., Kaku, M., Irifune, K., Mizukane, R., Takemura, H., Yoshida, R., Tanaka, H., Usui, T., Suyama, N., Tomono, K., Koga, H., Kohno, S., Izumikawa, K., Hara, K.:In vitro andin vivo activities of macrolides againstMycoplasma pneumoniae. Antimicrob. Agents Chemother. 38 (1994) 790–798.
Niki, Y., Kimura, M., Miyashita, N., Soejima, R.:In vitro andin vivo activities of azithromycin, a new azalide antibiotic, against chlamydia. Antimicrob. Agents Chemother. 38 (1994) 2296–2299.
Hammerschlag, M. R.: Antimicrobial susceptibility and therapy of infections caused byChlamydia pneumoniae. Antimicrob. Agents Chemother. 38 (1994) 1873–1878.
Welsh, L., Gaydos, C., Quinn, T. C.:In vitro activities of azithromycin, clarithromycin, erythromycin, and tetracycline against 13 strains ofChlamydia pneumoniae. Antimicrob. Agents Chemother. 40 (1996) 212–214.
Barry, A. L., Jones, R. N., Thornsberry, C.:In vitro activities of azithromycin (CP-62,993), clarithromycin (A-56268; TE-031), erythromycin, roxithromycin, and clindamycin. Antimicrob. Agents Chemother. 32 (1988) 752–754.
Johnson, D. M., Erwin, M. E., Barrett, M. S., Briggs Gooding, B., Jones, R. N.: Antimicrobial activity of ten macrolide, lincosamine and streptogramin drugs tested againstLegionella species. Eur. J. Clin. Microbiol. Infect. Dis. 11 (1992) 751–755.
Nimmo, G. R., Bull, J. Z.: Comparative susceptibility ofLegionella pneumophila andLegionella longbacheae to 12 antimicrobial agents. J. Antimicrob. Chemother. 36 (1995) 219–223.
Keysary, A., Itzhaki, A., Rubinstein, E., Oron, C., Keren, G.: Thein vitro anti-rickettsial activity of macrolides. J. Antimicrob. Chemother. 38 (1996) 727–731.
Foulds, G., Shepard, R. M., Johnson, R. B.: The pharmacokinetics of azithromycin in human serum and tissues J. Antimicrob. Chemother. 25 (Suppl. A) (1990) 73–82.
Morris, D. L., De Souza, A., Jones, J. A., Morgan, W. E.: High and prolonged pulmonary tissue concentrations of azithromycin following a single oral dose. Eur. J. Clin. Microbiol. Infect. Dis. 10 (1991) 859–861.
Baldwin, D. R., Wise, R., Andrews, J. M., Ashby, J. P., Honeybourne, D.: Azithromycin concentrations at the sites of pulmonary infection. Eur. Respir. J. 3 (1990) 886–890.
Schönwald, S., Gunjača, M., Kolačny-Babić, L., Car, V., Gošev, M.: Comparison of azithromycin and erythromycin in the treatment of atypical pneumonias. J. Antimicrob. Chemother. 25 (Suppl. A) (1990) 123–126.
Schönwald, S., Škerk, V., Petričević, I., Car, V., Majerus-Mišić, Lj., Gunjača, M.: Comparison of three-day and five-day courses of azithromycin in the treatment of atypical pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 10 (1991) 877–880.
Schönwald, S., Baršić, B., Klinar, I., Gunjača, M.: Three-day azithromycin compared with ten-day roxithromycin treatment of atypical pneumonia. Scand. J. Infect. Dis. 26 (1994) 706–710.
Kuzman, I., Schönwald, S., Čulig, J., Orešković, K.: Azithromycin, erythromycin and doxycycline in the treatment ofMycoplasma pneumoniae pneumonia: a retrospective study. In:Berkarda, B. (ed.). 10th Mediterranean Congress of Chemotherapy. Monduzzi Editore. Bologna 1996, pp. 211–214.
Kuzman, I., Orešković, K., Schönwald, S., Čulig, J.: Azithromycin in treatment of pneumonias caused byChlamydia spp.: a retrospective study. Int. J. Clin. Pharm. Res. 16 (1997) 103–107.
Kuzman, I., Soldo, I., Schönwald, S., Čulig, J.: Azithromycin for treatment of community-acquired pneumonia caused byLegionella pneumophila: a retrospective study. Scand. J. Infect. Dis. 27 (1995) 503–505.
Bohte, R., van't Wout, J.W., Lobatto, S., Blussé van Oud Alblas A., Boekhout, M., Nauta, E. H., Hermans, J., van den Broek, P. J.: Efficacy and safety of azithromycin versus benzylpenicillin or erythromycin in community-acquired pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 14 (1995) 182–187.
Sočan, M.: Treatment of atypical pneumonia with azithromycin: comparison of a 5-day and a 3-day course. J. Chemother. 10 (1998) 64–68.
Kuzman, I.: Community-acquired pneumonia: etiologic diagnosis and strategy of antibiotic therapy (doctoral thesis). Zagreb University, Zagreb 1994.
Tartakovskii, I. S., Sinopalnikov, A. J., Martinova, V. R., Gorina, L. G., Komissarov, A. L., Rakov, A. J., Prosorovskii, S. V.: Communityacquired pneumonia: etiologic diagnosis and strategy of antibiotic therapy. In: Legionella infections and atypical pneumonias. Proceedings of the 11th meeting of the European Working Group on Legionella Infections. Oslo, Norway, 2–4 June 1996. The Norwegian Defence Microbiological Laboratory, Joint Medical Services, HQ Defense Command Norway, Oslo 1996, pp. 149–152.
The Nordic Atypical Pneumonia Study Group: Atypical pneumonia in the Nordic countries: aetiology and clinical results of a trial comparing fleroxacin and doxycycline. J. Antimicrob. Chemother. 39 (1997) 499–508.
Lieberman, D., Ben-Yaakov, M., Lazarovich, Z., Porath, A., Schaeffer, F., Lieberman, D., Leinonen, M., Saikku, P., Horovitz, O., Boldur, I.: Chlamydia pneumoniae community-acquired pneumonia: a review of 62 hospitalized adult patients Infection 24 (1996) 109–114.
Baum S. G.: Mycoplasma pneumoniae and atypical pneumonia. In:Mandell, G. L., Bennett, J. E., Dolin, R. (eds.): Mandell, Douglas and Bennett's principles and practice of infectious diseases. Churchill Livingstone. New York 1995, pp. 1704–1713.
Grayston, T. J.: Chlamydia pneumoniae (TWAR). In:Mandell, G. L., Bennett, J. E., Dolin R. (eds.). Mandell, Douglas and Bennett's principles and practice of infectious diseases. Churchill Livingstone. New York 1995, pp. 1696–1701.
Stout, J. E., Yu, V. L.: Legionellosis. N. Engl. J. Med. 337 (1997) 682–687.
Marrie, T. J.:Coxiella burnetii (Q fever). In:Mandell, G. L., Bennett, J. E., Dolin, R. (eds.): Mandell, Douglas and Bennett's principles and practice of infectious diseases. Churchill Livingstone. New York 1995, pp. 1727–1735.
Fitzgeorge, R. B., Featherstone, A. S. R., Baskerville, A.: Efficacy of azithromycin in the treatment of guinea pigs infected with,Legionella pneumophila by aerosol. J. Antimicrob. Chemother. 25 (Suppl. A) (1990) 101–108.
Fitzgeorge, R. B., Lever, S., Baskerville, A.: A comparison of the efficacy of azithromycin and clarithromycin in oral therapy of experimental airborne legionnaires' disease. J. Antimicrob. Chemother. 31 (Suppl. E) (1993) 171–176.
Malinverni, R., Kuo, C. C., Campbell, L. A., Lee, A., Grayston, J. T.: Effects of two antibiotic regimens on course and persistence of experimentalChlamydia pneumoniae TWAR pneumonitis. Antimicrob. Agents Chemother. 39 (1995) 45–49.
Cunha, B. A.: The antibiotic treatment of community-acquired, atypical, and nosocomial pneumonias. Med. Clin. North Am. 79 (1995) 581–597.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schönwald, S., Kuzman, I., Orešković, K. et al. Azithromycin: Single 1.5g dose in the treatment of patients with atypical pneumonia syndrome—A randomized study. Infection 27, 198–202 (1999). https://doi.org/10.1007/BF02561528
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF02561528