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OBJECTIVE: To determine the in vitro antimicrobial activity, postantibiotic effect (PAE) and human monocyte activity of grepafloxacin compared with sparfloxacin, ciprofloxacin, clarithromycin, erythromycin and rifampicin against 181 strains of Legionella pneumophila, nine strains of L. micdadei, 10 strains of L. dumoffii, seven strains of L. longbeachae and seven other Legionella strains. METHODS: MICs were determined by standard agar dilution using buffered yeast extract (BYE) agar. PAE and human monocyte activity were determined by standard culture techniques. RESULTS: Grepafloxacin, sparfloxacin and rifampicin were the most active agents against L. pneumophila (MIC90

We performed a single blind controlled multicenter study in which we compared the efficacy and safety of 100 mg of doxycycline versus those of 1 g (3 x 106 IU) of spiramycin given orally twice daily for 14 days in the treatment of culture-positive Chlamydia trachomatis genitourinary tract infections. A total of 367 patients were enrolled in the study, and 364 patients were evaluable for safety and 265 patients were evaluable for efficacy. The cure rate between treatment groups was not statistically significant, being 98% (125 of 128 patients) in the spiramycin group and 100%o (133 of 133 patients) in the doxycycline group. Female patients who received spiramycin were more likely to report dysethesias that resolved after the completion of therapy. The results of the study show that spiramycin is an effective drug for the treatment of C. trachomatis infection and warrants further assessment over a shorter treatment period (7 days) and during pregnancy.Chlamydia trachomatis is a frequent cause of sexually transmitted disease and is associated with significant morbidity in women and neonates. The antibiotic of choice for the treatment of C trachomatis infections is a tetracycline, with macrolides reserved for second-line treatment or during pregnancy (5). The success rate in eradicating genital tract infections with tetracyclines given for at least 7 days is greater than 90% (5). Spiramycin is a macrolide antibiotic with a range of MICs for C. trachomatis of 0.025 to 2.0 ,ug/ml (4). The drug is concentrated intracellularly (2) and has been used extensively in Europe for the treatment of toxoplasmosis during pregnancy (1). The purpose of the present study was to compare the efficacy and safety of spiramycin with those of doxycycline for the treatment of culture-proven C. trachomatis genital infections.Patients of either sex over the age of 18 years were asked to participate in a single blind controlled multicenter study comparing oral doxycycline, 100 mg, versus spiramycin, 1 g (3 x 106 IU) given twice daily for 14 days. For patients to be eligible for entry into the study, they had to have a positive rapid detection test result for C. trachomatis at the infection site (endocervix or urethra) with subsequent confirmation by cell culture techniques. Patients were excluded from the study if they had concomitant infections, recent antibiotic therapy, complicated genitourinary tract infections such as prostatitis or salpingitis, drug hypersensitivity, or significant hepatic or renal impairment.Women of childbearing age were required to use a recognized contraceptive method during the study. All patients were asked to refrain from sexual activity until the first posttreatment follow-up visit and to use condoms until the end of the study. They were asked to avoid antacids in order not to reduce the absorption rate of doxycycline.At the initial visit, the medical history was obtained and a physical examination was performed. Samples were taken for Chlamydia antigen detection and culture, and blood and urine specimens were t...