Levofloxacin versus azithromycin for treating legionella pneumonia: a propensity score analysis

García-Vidal, Carolina; Sánchez-Rodríguez, Iván; Simonetti, Antonella; Burgos, Joaquín; Viasus, Diego; Martín, María-Teresa; Falcó, Vicenç; Carratalà, Jordi

doi:10.1016/j.cmi.2017.02.030

Cited by 39 publications

(26 citation statements)

References 24 publications

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“…Conventionally, levofloxacin, which is a fluoroquinolone antibiotic, is bactericidal and has been considered the first-line drug for Legionnaires' disease ( 19 - 21 ). However, the latest research showed that the effects were not markedly different between levofloxacin and intravenous azithromycin, which is a macrolide antibacterial agent ( 22 ). Ciprofloxacin, pazufloxacin, levofloxacin, garenoxacin, moxifloxacin, clarithromycin, azithromycin, and rifampicin were all shown to have relatively good antibacterial activity against Legionella with no resistant strains ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Fatal Fulminant Legionnaires' Disease in a Patient on Maintenance Hemodialysis

et al. 2020

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We herein report a case of fulminant Legionnaires' disease with autopsy findings in a patient on maintenance hemodialysis (HD). Chronic kidney disease is a strong risk factor for Legionnaires' disease, although there have been only a few reports in HD patients. Because most patients on HD are anuric, the use of rapid assay kits to detect antigens in urine samples for the diagnosis of Legionnaires' disease is not always feasible. We suggest the use of clinical predictive tools or the loop-mediated isothermal amplification (LAMP) method, which can be applied for anuric patients, such as those on HD, with pneumonia.

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Section: Discussionmentioning

confidence: 99%

Fatal Fulminant Legionnaires' Disease in a Patient on Maintenance Hemodialysis

et al. 2020

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“…After a good clinical response is detected, it can be switched to the oral route. In patients with severe disease or unresponsive to monotherapy, the addition of rifampin is recommended [45,50]. The recommended Azithromycin dose is 500 mg IV/PO q24h for 5 days.…”

Section: Treatmentmentioning

confidence: 99%

A Clinical Overview of Hospital-Acquired Legionella Pneumonia: Prevention Is the Key?

Mendez¹,

Rueda²,

García³

et al. 2020

Hospital Acquired Infection and Legionnaires' Disease

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Legionella pneumophila is a Gram-negative bacteria that cause communityacquired pneumonia in very common circumstances. Although it is rare to develop hospital-acquired pneumonia due to Legionella pneumophila, there are cases where the infection appears during its presence in the hospital environment or because of the existence of Legionella outbreaks. It is important to mention that the colonization of this organism is mostly found in some hospital water supplies. The prevention of the spreading of this nosocomial pathogen is crucial for the hospital setting by identification of the bacteria. Using surveillance and control of infection, as well as maintaining beneficial isolation of those patients with the disease, could prevent the dissemination of this rare infection among hospitalized patients that are highly vulnerable. The treatment should be effective and according to the standard of care guidelines. The initiation of empiric antibiotic therapy is critical once the pathogen is suspected to be the etiology of pneumonia.

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“…Primary outcome was overall 30-day in-hospital mortality. Thirty-six patients were excluded, 175 patients received levofloxacin, 177 patients received azithromycin and 58 patients received clarithromycin, without statistical significant difference for in-hospital 30-day mortality between the cohorts [24].…”

Section: Targeted Therapymentioning

confidence: 99%

Legionnaires’ Disease Treatment

Velazco¹

2020

Hospital Acquired Infection and Legionnaires' Disease

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Legionnaires' disease is an important cause of community-acquired pneumonia as well as hospital-acquired pneumonia. Legionella pneumophila is an important but uncommon respiratory pathogen with significant morbidity and mortality. Initially recognized as a fatal cause of pneumonia in the 1970s. Untreated Legionnaires' disease conveys high mortality, therefore a prompt treatment with appropriate antibiotics is of extreme importance. Currently, therapeutic options include macrolides and fluoroquinolones mainly, that have an effective therapeutic profile. Potential issues of bacterial resistance have risen, but overall, this is not a significant limitation of therapy. In addition, attempts to identify other cases related to the case will help find potential sources.

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Levofloxacin versus azithromycin for treating legionella pneumonia: a propensity score analysis

Abstract: In our study, no significant differences in most outcomes were found between patients treated with levofloxacin and those treated with azithromycin. Due to the small number of deaths, results regarding mortality should be interpreted with caution.

Cited by 39 publications

References 24 publications

Fatal Fulminant Legionnaires' Disease in a Patient on Maintenance Hemodialysis

Fatal Fulminant Legionnaires' Disease in a Patient on Maintenance Hemodialysis

A Clinical Overview of Hospital-Acquired Legionella Pneumonia: Prevention Is the Key?

Legionnaires’ Disease Treatment

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