Azithromycin versus comparative therapy for the treatment of community acquired pneumonia

Rahav, Galia; Fidel, Joseph; Gibor, Yair; Shapiro, Mervyn

doi:10.1016/j.ijantimicag.2004.01.011

Cited by 23 publications

(17 citation statements)

References 20 publications

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“…12 Although the causal pathogen was not confirmed in this study, the current CAP clinical practice guidelines recommend against obtaining sputum for Gram stain and culture routinely in outpatients. 3,12 In other words, the guideline recommendation suggests that empiric treatment is sufficient in most outpatients. With this in mind, one can conclude that 3-day azithromycin is an appropriate empiric treatment of CAP in outpatients based on the study by Rahav et al…”

Section: Therapeutic Efficacy Of 3-day Azithromycin Versus Other Anti...mentioning

confidence: 61%

“…12 Nausea was the only reported adverse effect occurring in 3 (4.8%) azithromycin-treated patients versus 0 other antibiotic-treated patients (P = 0.12). 12 Although the causal pathogen was not confirmed in this study, the current CAP clinical practice guidelines recommend against obtaining sputum for Gram stain and culture routinely in outpatients. 3,12 In other words, the guideline recommendation suggests that empiric treatment is sufficient in most outpatients.…”

Section: Therapeutic Efficacy Of 3-day Azithromycin Versus Other Anti...mentioning

confidence: 92%

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Short-Course Azithromycin for Lower Respiratory Tract Infection in Adults

Rattanasuwan

Ebied

Khoury

2021

Infect Dis Clin Pract

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Azithromycin, a macrolide antibiotic, has been shown to be effective in community-acquired pneumonia (CAP). The long half-life of azithromycin allows for a shortened treatment course, whereas the drug level is sufficiently maintained in the blood. The objective of this study is to review the body of evidence on the efficacy and safety of azithromycin in CAP treatment given as a regimen of 500 mg daily for 3 days. An English-language literature search was completed through PubMed . Full-text studies conducted in humans to compare a 5-day azithromycin course with a 3-day azithromycin course or azithromycin with other antibiotics for CAP treatment were included. Although the standard recommended CAP treatment regimen of azithromycin is 1500 mg in a total dose divided for 5 days, the efficacy of 1500 mg in a total dose divided for 3 days has been shown to be as effective as the 5-day course and comparable to longer durations of clarithromycin or amoxicillin/clavulanate for CAP treatment in an outpatient setting. Meanwhile, the evidence is less supportive of the use of 3-day azithromycin in patients who require hospitalization. The risk of cardiac death is low and not greater than the risk with other antibiotics.

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Section: Therapeutic Efficacy Of 3-day Azithromycin Versus Other Anti...mentioning

confidence: 61%

Section: Therapeutic Efficacy Of 3-day Azithromycin Versus Other Anti...mentioning

confidence: 92%

Short-Course Azithromycin for Lower Respiratory Tract Infection in Adults

Rattanasuwan

Ebied

Khoury

2021

Infect Dis Clin Pract

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“…Эффективность коротких курсов азитромицина при внебольничной пневмонии была продемонстри рована в нескольких проведенных ранее исследова ниях [9][10][11][12][13][14][15][16]. В открытом проспективном рандоми зированном мультицентровом исследовании Rahav et al сравнивали эффективность 3 дневной терапии азитромицином и 10 дневной терапии другими ан тибиотиками (эритромицин, амоксициллин / клаву ланат, рокситромицин, доксициклин, цефуроксима аксетил и цефаклор) у амбулаторных пациентов с внебольничной пневмонией [16]. Группы больных были сравнимы между собой по возрасту и тяжести заболевания.…”

Section: Discussionunclassified

“…Азитромицин (Зит ролид форте) хорошо переносился больными, не было отмечено развития серьезных побочных реакций, требующих отмены препарата. остальными макролидами, а также большинством ан тибиотиков других групп является однократный при ем в сутки и возможность использования коротких курсов лечения (в течение 3 дней), что удобно для больных [9][10][11][12][13][14][15][16]. В результате повышается аккурат ность выполнения терапевтических рекомендаций и уменьшается риск селекции резистентных штаммов [17].…”

Section: резюмеunclassified

Efficacy of short course asythromycin in non-severe community-acquired pneumonia

Чучалин¹,

Авдеев²,

Tsareva³

2007

Pulʹmonologiâ (Mosk.)

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The study was aimed to evaluate clinical efficacy, safety, and tolerability of 3 day course of azythromycin (Zitrolid forte) in comparison with a stan dard 7 to 10 day therapy with amoxicillin (Flemoxin solutab) in patients with mild community acquired pneumonia (CAP). Included patients were randomized in 2 groups: 1) 20 patients taking Zitrolid 500 mg daily for 3 days (15 males, 5 females, mean age, 40.7 ± 18.4 yrs); 2) 20 patients taking amoxicillin 500 mg t.i.d. for 7 to 10 days (13 males, 7 females, mean age, 39.8 ± 12.5 yrs). Pneumonia was confirmed by chest X ray in all the patients. Severity of pneumonia was assessed with PSI score. In the 1st group, 12 (60 %) of patients had PSI class I and 8 (40 %) had PSI class II. In the 2nd group, there were 13 (65 %) and 7 (35 %), respectively. In the 1st group patients, improvement in clinical signs and laboratory parame ters was noted at the 3rd day of therapy and complete recovery was detected at the 7th day. The 2nd group patients demonstrated similar dynamics at the 7th and the 14th days, respectively. Microbiological efficacy of the drugs was equal (100 %). The drugs did not differ in rate of adverse events. Therefore, 3 day course of azythromycin in patients with mild CAP were as effective as standard (7 to 10 days) therapy with amoxicillin. Azythromycin (Zitrolid forte) was well tolerated with no serious adverse events requiring interruption the treatment.

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“…[9][10][11] Recent randomised controlled trials (RCTs) have compared three versus eight days of therapy in both outpatients and those requiring hospital admission for CAP, and have reported satisfactory outcomes of clinical improvement and stability, improved adherence and fewer adverse effects in those receiving the shorter duration. [12][13][14][15][16][17][18][19][20] Whether these trials will motivate a change in recommendations remains uncertain.…”

Section: Open Accessmentioning

confidence: 99%

Shorter versus longer durations of antibiotic treatment for patients with community-acquired pneumonia: a protocol for a systematic review and meta-analysis

et al. 2022

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IntroductionCommunity-acquired pneumonia (CAP), frequently encountered in both outpatient and inpatient settings, is the leading cause of infectious disease-related mortality. While equipoise regarding the optimal duration of antimicrobial therapy to treat CAP remains, recent studies suggest shorter durations of therapy may achieve optimal outcomes. We have therefore planned a systematic review and meta-analysis evaluating the impact of shorter versus longer durations of antibiotic therapy for patients with CAP.Methods and analysisWe searched Ovid MEDLINE, Embase, CINAHL and Cochrane Central Register of Controlled Trials from inception to September 2021 for randomised controlled trials evaluating shorter versus longer duration of antibiotics. Eligible studies will compare durations with a minimum difference of two days of antibiotic therapy, irrespective of antibiotic agent, class, route, frequency or dosage, and will report on any patient-important outcome of benefit or harm. Paired reviewers working independently will conduct title and abstract screening, full-text screening, data extraction and risk of bias (RoB) evaluation using a modified Cochrane RoB 2.0 tool. We will perform random-effects modelling for meta-analyses, with study weights generated using the inverse variance method, and will assess certainty in effect estimates using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The Instrument for assessing the Credibility of Effect Modification Analyses (ICEMAN) tool will inform assessments of credibility of subgroup effects based on severity of illness, drug class, duration of therapy, setting of CAP acquisition and RoB.Ethics and disseminationThe results will be of importance to general practitioners and internists managing CAP, and may directly inform international clinical guidance. Where concerns regarding antimicrobial resistance continue to grow internationally, this evidence summary may motivate new recommendations regarding shorter durations of therapy. We intend to disseminate our findings via national and international conferences, and publication in a peer-reviewed journal.PROSPERO registration numberCRD42021283990.

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Azithromycin versus comparative therapy for the treatment of community acquired pneumonia

Cited by 23 publications

References 20 publications

Short-Course Azithromycin for Lower Respiratory Tract Infection in Adults

Short-Course Azithromycin for Lower Respiratory Tract Infection in Adults

Efficacy of short course asythromycin in non-severe community-acquired pneumonia

Shorter versus longer durations of antibiotic treatment for patients with community-acquired pneumonia: a protocol for a systematic review and meta-analysis

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