Azithromycin in the Treatment of Legionella Pneumonia Requiring Hospitalization

• Published in: Clinical infectious diseases Vol. 37; no. 11; pp. 1475 - 1480
• Main Authors: Plouffe, Joseph F., Breiman, Robert F., Fields, Barry S., Herbert, Mark, Inverso, Jill, Knirsch, Charles, Kolokathis, Antonia, Marrie, Thomas J., Nicolle, Lindsay, Schwartz, Douglas B.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-12-2003; University of Chicago Press
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antigens; Antimicrobials; azithromycin; Azithromycin - adverse effects; Azithromycin - therapeutic use; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Community-Acquired Infections - drug therapy; Dosage; Female; Hospitalization; Human bacterial diseases; Humans; Infections; Infectious diseases; Legionella; Legionella pneumophila; Legionnaires disease; Legionnaires' Disease - drug therapy; Major Articles; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pneumonia; Symptoms; Treatment Outcome; Animal model; Pneumonia; Intravenous administration; Azithromycin; Legionella pneumophila; Legionellosis; Legionella; Legionnaires disease; Bacteria; Human; Lung disease; Drug combination; Legionellaceae; Respiratory disease; Cure; Rate; Serogroup; Oral administration; Duration; Hospitalization; Macrolide; Infection; Antigen; Symptomatology; Antibiotic; Community acquired infection; Treatment; Bacteriosis; Antibacterial agent
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/379329

Azithromycin is highly active against Legionella pneumophila and has been shown to be efficacious in animal models and in clinical studies of patients with legionnaires disease. This open, prospective, multicenter trial evaluated azithromycin for the treatment of legionnaires disease. Twenty-five hospitalized patients with community-acquired pneumonia and a positive result of a L. pneumophila serogroup 1 urinary antigen assay received monotherapy with intravenous azithromycin (500 mg/day) for 2–7 days, followed by oral azithromycin (1500 mg administered over the course of 3 or 5 days). The mean total duration of intravenous plus oral therapy was 7.92 days. The overall cure rate among clinically evaluable patients was 95% (20 of 21 patients) at 10–14 days after therapy and 96% (22 of 23 patients) at 4–6 weeks after therapy. The results of this study support previously reported data demonstrating that azithromycin is both safe and efficacious for the treatment of hospitalized patients with legionnaires disease.