Once-daily azithromycin in the treatment of adult skin and skin-structure infections

Abstract

The aim of this prospective, blinded, randomized study was to demonstrate the efficacy and safety of oral azithromycin and dicloxacillin in the treatment of adults with acute skin and skin-structure infections. Sixty-two patients were included in the intent-to-treat group and 60 were evaluable for analysis. Azithromycin was given as a 500 mg once-daily dose for three days and dicloxacillin as 250 mg qid for seven days. Isolated pathogens included primarily Staphylococcus aureus, Streptococcus spp., and coagulase-negative staphylococci. Clinical resolution was 83.3% in the azithromycin group and 83.9% in the dicloxacillin group, with bacteriological eradication of 90.0% in the azithromycin group and 87.1% in the dicloxacillin group. Persistence of infection was recorded in one patient in the dicloxacillin group and superinfection in one patient in the azithromycin group. Azithromycin appears to be a safe and effective antibiotic for the treatment of adult patients with acute skin and skin-structure infections.

Comparison of Short-Course (5 Days) and Standard (10 Days) Treatment for Uncomplicated Cellulitis

“…To our knowledge, the only trials that have administered therapeutic courses of less than 7 days involved newer macrolides. [18][19][20][21][22] These medications, especially azithromycin, have prolonged functional half-lives in tissue, and introduce difficulties with interpretation of the duration of antibiotic effect. Additionally, these trials were not designed to assess duration of therapy in isolation, as they did not compare a medication with itself; rather, they compared a newer antibiotic with an older, more established antibiotic for the treatment of cellulitis.…”

Prevention of chronic furunculosis with low‐dose azithromycin

“…In contrast to other antibiotics used in chronic furunculosis, azithromycin has a long tissue half-life that allows the dosing schedule of three times a week (5). Similar to the dose regimen we used in our study, dosage may be tapered when remission of active furuncles has been achieved.…”

“…Azithromycin is a macrolide antibiotic which has been shown to be effective in skin and soft tissue infections (4,5). It has unique pharmacokinetics that give rise to prolonged tissue levels and allows less frequent dosage (4).…”

Treatment of bullous impetigo and the staphylococcal scalded skin syndrome in infants

“…As sedating antihistamines are frequently used in children and adults with chronic pruritic skin disease, such as atopic dermatitis, which can in turn become frequently infected with S. aureus, prescribers must take care when considering the use of erythromycin in this patient group. A single daily dose of oral azithromycin has been shown to be equally as effective as dicloxacillin [25].…”