Azithromycin for CAP.
by Worcester, Sharon
Azithromycin led to significantly shorter hospital stays and lower
mortality than clarithromycin in elderly patients with
community-acquired pneumonia in an open-label prospective study.
Of 603 patients, 383 received ceftriaxone plus a 3-day course of
azithromycin, and 220 received ceftriaxone plus a 10-day course of
clarithromycin. Azithromycin patients were older (mean of 71.5 years vs.
65.8 years), but disease severity and bacteremia incidence did not
differ between the two groups, reported Dr. E Sanchez of the Hospital
Clinic of Barcelona (Spain) and colleagues.
The mean hospital stay was 7.3 days for the azithromycin group and
9.4 days for the clarithromycin group. The mortality rate was 3.7% in
the azithromycin group and 7.3% in the clarithromycin group (Clin.
Infect. Dis. 36[10]:1239-45, 2003).
The findings of this nonrandomized study suggest that azithromycin
is a good treatment for community-acquired pneumonia in the elderly.
This might reflect improved compliance with the shorter course and
once-daily azithromycin dosing, they said, noting that the results
should serve as a springboard for randomized studies.
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