Susceptibility surveillance of U.S. respiratory pathogen isolates to newer macrolide and azalide antibiotics

Brown, Steven D.; Barry, Arthur L.; Burton, Peter

doi:10.1016/0924-8579(96)00010-6

Cited by 6 publications

(1 citation statement)

References 19 publications

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“…Dirithromycin and clarithromycin have similar antibacterial coverage for community-acquired respiratory pathogens (Table 1). [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] In general, clarithromycin has lower MIC 90 values (≥ 1 dilutions) for most gram-positive and gramnegative pathogens. Dirithromycin usually has an adequate MIC 90 to inhibit the same bacteria as clarithromycin, including atypical respiratory pathogens such as Legionella sp, 44,45,55 Mycoplasma pneumoniae, 54,59,60 and Chlamydia pneumoniae.…”

Section: Microbiologymentioning

confidence: 99%

Review and Comparison of Advanced‐Generation Macrolides Clarithromycin and Dirithromycin

McConnell

Amsden

1999

Pharmacotherapy

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We reviewed English-language clinical studies, abstracts, and review articles identified from MEDLINE searches from January 1966-August 1998, and bibliographies of identified articles to compare advanced-generation macrolides dirithromycin and clarithromycin and their use for respiratory tract infections. Both agents have superior adverse effect profiles compared with erythromycin, the original macrolide. Both have broad antibacterial coverage, but clarithromycin usually has a lower MIC90 to susceptible organisms than dirithromycin; for most isolates this difference is not clinically significant. Clarithromycin has better in vitro coverage of Haemophilus influenzae, but this activity varies with formation of its bioactive metabolite, 14-hydroxyclarithromycin. Neither agent is ideal for H. influenzae eradication. The agents differ markedly in terms of pharmacokinetics, pharmacodynamics, metabolism, and cost, and thus with respect to drug interaction profiles and dosages. Dirithromycin's drug interaction profile is markedly better than clarithromycin's. Clarithromycin is dosed twice/day; dirithromycin's pharmacokinetics allow once/day dosing. Dirithromycin is less expensive with regard to both cost/day and cost/treatment regimen. Clarithromycin has been studied and approved for administration to children. In adults with respiratory tract infections who are receiving drugs that would interact with clarithromycin, and in those with renal dysfunction with or without coexisting hepatic dysfunction, dirithromycin appears to be superior in terms of safety and equivalent to clarithromycin in terms of efficacy.

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Section: Microbiologymentioning

confidence: 99%

Review and Comparison of Advanced‐Generation Macrolides Clarithromycin and Dirithromycin

McConnell

Amsden

1999

Pharmacotherapy

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Randomized, Multicentre Study of the Efficacy and Tolerance of Azithromycin versus Clarithromycin in the Treatment of Adults with Mild to Moderate Community-Acquired Pneumonia

O’Doherty

Müller²

1998

European Journal of Clinical Microbiology & Infectious Dise

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Adults with mild to moderate community-acquired pneumonia were treated with azithromycin (500 mg once daily for 3 days) or clarithromycin (250 mg twice daily for 10 days) and clinically assessed between days 3 and 7 and days 12 and 16. Patients classified as improved at the day 12-16 visit were also evaluated between days 19 and 23. Two hundred three patients were treated (101 with azithromycin, 102 with clarithromycin). A satisfactory clinical response was recorded at the end of therapy in 83 of 88 (94%) evaluable azithromycin-treated and 84 of 88 (95%) evaluable clarithromycin-treated patients (P=0.518). At day 19-23, only one patient in each treatment group had relapsed. Thirty-one of 32 (97%) pathogens isolated from patients in the azithromycin group were eradicated, compared with 32 of 35 (91%) isolated from clarithromycin patients. In all patients with atypical pneumonia, the clinical response was satisfactory at follow-up. Incidences of treatment-related adverse events were similar for the two groups (P=0.815). Two (2%) clarithromycin patients discontinued therapy due to severe treatment-related adverse events; none in the azithromycin group did. This study shows that a 3-day, once-daily course of azithromycin is as clinically effective and well tolerated as a 10-day, twice-daily course of clarithromycin in the treatment of mild to moderate community-acquired pneumonia.

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Erythromycin, clarithromycin, and azithromycin: are the differences real?

Amsden

1996

Clinical Therapeutics

122

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Susceptibility surveillance of U.S. respiratory pathogen isolates to newer macrolide and azalide antibiotics

Cited by 6 publications

References 19 publications

Review and Comparison of Advanced‐Generation Macrolides Clarithromycin and Dirithromycin

Review and Comparison of Advanced‐Generation Macrolides Clarithromycin and Dirithromycin

Randomized, Multicentre Study of the Efficacy and Tolerance of Azithromycin versus Clarithromycin in the Treatment of Adults with Mild to Moderate Community-Acquired Pneumonia

Erythromycin, clarithromycin, and azithromycin: are the differences real?

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