This open, randomised clinical study, conducted from June 1988 to December 1989, included 84 patients with clinical and radiological findings of atypical pneumonia. All patients were treated with a total dose of 1.5 g azithromycin, a new azalide antibiotic. In Group I, azithromycin was administered for three days (500 mg once daily). In Group II, azithromycin was administered for five days (250 mg b.i.d. on day 1, followed by 250 mg once daily on days 2 to 5). Causative pathogens were identified by serological methods. Of the 41 patients in Group I, Mycoplasma pneumoniae, Chlamydia psittaci and Coxiella burnetti were identified in 19, 4 and 3 patients, respectively. In Group II there were 43 patients; Mycoplasma pneumoniae was identified in 24, Chlamydia psittaci in 4 and Coxiella burnetti in 3. Only patients with known causative pathogens were included in the evaluation of clinical efficacy. All patients were clinically cured by day 5; most of the patients became afebrile within 48 h of starting treatment. Side effects were observed in one patient in Group I and in one patient in Group II. The results suggest that a 1.5 g total dose of azithromycin is equally effective when administered as a three- or five-day regimen for the treatment of atypical pneumonia.
An open, randomized, multicentre study compared the efficacy and safety of the prototype, azalide, azithromycin, and erythromycin in the treatment of atypical pneumonias. Azithromycin was administered for five days at a dosage of 250 mg bd on day 1 and 250 mg once daily on days 2 to 5. Erythromycin was given for ten days at 500 mg qid. Causative pathogens were identified by serological methods. Of 57 patients treated with azithromycin, Mycoplasma pneumoniae and Chlamydia psittaci were identified in 31 and eight patients, respectively. Of 44 patients treated with erythromycin, M. pneumoniae and C. psittaci were identified in 24 and eight patients, respectively. There were no therapeutic failures in either treatment group. Side effects were observed in one of 57 patients on azithromycin and in six of 44 patients on erythromycin. Azithromycin appears to be as effective as erythromycin in the treatment of atypical pneumonias and better tolerated.
An open, randomized, multicentre study compared the efficacy and safety of 3-day azithromycin with 10-day roxithromycin for the treatment of atypical pneumonia. Azithromycin was administered 500 mg once daily to 90 and roxithromycin 150 mg bid to 60 patients. Causative pathogens were identified by serological methods. In the azithromycin treatment group, Mycoplasma pneumoniae was identified in 65, Chlamydia spp. in 9 and Coxiella burnetti in 1 patient. In the roxithromycin treatment group, M. pneumoniae was identified in 39, Chlamydia spp. in 9 and C. burnetti in 3 patients. 89 azithromycin and 53 roxithromycin patients were eligible for efficacy analysis. Clinical cure rate was 98.9% in the azithromycin and 94.3% in the roxithromycin treatment group. Adverse events were observed in 3 patients in each group. Azithromycin appears to be as effective as roxithromycin for the treatment of atypical pneumonia. The 3-day azithromycin regimen may offer an additional advantage over 10-day roxithromycin by virtue of its more convenient administration.
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