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Clinical and bacteriological outcomes in hospitalised patients with community-acquired pneumonia treated with azithromycin plus ceftriaxone, or ceftriaxone plus clarithromycin or erythromycin: a prospective, randomised, multicentre study.
Journal article

Clinical and bacteriological outcomes in hospitalised patients with community-acquired pneumonia treated with azithromycin plus ceftriaxone, or ceftriaxone plus clarithromycin or erythromycin: a prospective, randomised, multicentre study.

  • Tamm M Division of Pneumology, University Hospital Basel, Basel, Switzerland. Electronic address: MTamm@uhbs.ch.
  • Todisco T Pulmonary Division and Respiratory ICU, Silvestrini Hospital, Perugia, Italy.
  • Feldman C Division of Pulmonology, Department of Medicine, Johannesburg Hospital and University of the Witwatersrand, Johannesburg, South Africa.
  • Garbino J Infectious Diseases Division, University Hospital, Geneva, Switzerland.
  • Blasi F University of Milan, IRCCS, Policlinico, Milan, Italy.
  • Hogan P Pfizer, New York, NY, USA.
  • de Caprariis PJ Pfizer, New York, NY, USA.
  • Hoepelman IM Department of Internal Medicine and Infectious Diseases, University Medical Centre, Utrecht, The Netherlands.
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  • 2007-03-03
Published in:
  • Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. - 2007
Administration, Oral
Aged
Aged, 80 and over
Anti-Bacterial Agents
Azithromycin
Ceftriaxone
Clarithromycin
Community-Acquired Infections
Drug Therapy, Combination
Erythromycin
Female
Hospitalization
Humans
Injections, Intravenous
Male
Middle Aged
Pneumonia
Prospective Studies
Random Allocation
Treatment Outcome
English This study compared patients with moderate-to-severe community-acquired pneumonia (CAP) requiring hospitalisation, who received initial therapy with either intravenous ceftriaxone plus intravenous azithromycin, followed by step-down to oral azithromycin (n = 135), with patients who received intravenous ceftriaxone combined with either intravenous clarithromycin or erythromycin, followed by step-down to either oral clarithromycin or erythromycin (n = 143). Clinical and bacteriological outcomes were evaluated at the end of therapy (EOT; day 12-16) or at the end of study (EOS; day 28-35). At baseline, mean APACHE II scores were 13.3 and 12.6, respectively, with >50% of patients classified as Fine Pneumonia Severity Index (PSI) category IV or V. Clinical success rates (cure or improvement) in the modified intent-to-treat (MITT) population at EOT were 84.3% in the ceftriaxone/azithromycin group and 82.7% in the ceftriaxone/clarithromycin or erythromycin group. At EOS, MITT success rates (cure only) were 81.7% and 75.0%, respectively. Equivalent success rates in the clinically evaluable population were 83% and 87%, respectively, at EOT, and 79% and 78%, respectively, at EOS. MITT bacteriological eradication rates were 73.2% and 67.4%, respectively, at EOT, and 68.3% vs. 60.9%, respectively, at EOS. Mean length of hospital stay (LOS) was 10.7 and 12.6 days, and the mean duration of therapy was 9.5 and 10.5 days, respectively. The incidence of infusion-related adverse events was 16.3% and 25.2% (p 0.04), respectively. An intravenous-to-oral regimen of ceftriaxone/azithromycin was at least equivalent in efficacy and safety to the comparator regimen and appeared to be a suitable treatment option for hospitalised patients with CAP.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/117899
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