EFFICACY OF A 3 DAY COURSE OF AZITHROMYCIN IN MODERATELY SEVERE COMMUNITY-ACQUIRED PNEUMONIA
EFFICACY OF A 3 DAY COURSE OF AZITHROMYCIN IN MODERATELY SEVERE COMMUNITY-ACQUIRED PNEUMONIA
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DOI：
10.1183/09031936.95.08030398
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发表时间：
1995-03-01
影响因子：
24.3
通讯作者：
MAGLIANO, E
中科院分区：
文献类型：
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作者：
RIZZATO, G;MONTEMURRO, L;MAGLIANO, E
本研究旨在评估阿奇霉素3天疗程治疗中重度社区获得性肺炎的疗效。40例低重度至中重度社区获得性肺炎患者（男性29例，女性11例，平均年龄46+/-17岁；入院前接受β他坦治疗2-10天无结果的20例；有证据表明合并发病）被纳入一项开放、随机研究，分别接受阿奇霉素500 mg每日口服治疗3天，克拉霉素250 mg每日口服治疗10+/-2天。18例患者经血清学鉴定为肺炎病原学（肺炎支原体9例，肺炎衣原体4例，嗜肺军团菌5例；1例衣原体感染患者同时存在肺炎克雷伯菌血症）。对另外3例患者（1例流感嗜血杆菌，2例副流感嗜血杆菌）的痰培养进行了假定的病原学诊断，所有菌株均为具有10(8)菌落形成单位（CFU）的单独分离株，1例肺炎链球菌患者进行了革兰氏染色。阿奇霉素组1例（第2个3天疗程后1例）和克拉霉素组2例（可评估者中2例除外）均治愈，术后2.6+/-1.6 d退热，术后8.9+/-3.3 d胸片清零，两组无差异。耐受性很好，而且没有停药。阿奇霉素和克拉霉素可能是治疗低重度至中重度社区获得性肺炎的首选方法，但3天疗程的阿奇霉素可能会增加患者的依从性。
This study was designed to evaluate the efficacy of a 3 day course of azithromycin in low to moderately severe community-acquired pneumonia.Forty patients with low to moderately severe community-acquired pneumonia (29 males, 11 females, mean age 46+/-17 yrs; 20 pretreated with betalactams for 2-10 days with no results before admission to hospital; Is with evidence of co-morbidity) were enrolled in an open, randomized study with azithromycin, 500 mg q.d. oral therapy for 3 days, versus clarithromycin, 250 mg b.i.d. oral therapy for 10+/-2 days.The aetiology of pneumonia was identified in 18 patients by serology (nine Mycoplasma pneumoniae, four Chlamydia pneumoniae, five Legionella pneumophila; one patient with chlamydial infection also had Klebsiella pneumoniae bacteraemia). A presumptive aetiological diagnosis was obtained with sputum culture in three other patients (one Haemophilus influenzae, two Haemophilus parainfluenzae), all strains were sole isolates with 10(8) Colony forming units (CFU), and with Gram stain in one patient with Streptococcus pneumoniae. All patients in the azithromycin group (one after a second 3 day course), and all but two (of those available for evaluation) of the clarithromycin group were cured, Defervescence occurred after 2.6+/-1.6 days, and chest roentgenogram cleared after 8.9+/-3.3 days, with no difference between the two groups. Tolerance was good, and there were no withdrawals from therapy.Azithromycin, as well as clarithromycin, may be a good first choice approach for the treatment of low to moderately severe community-acquired pneumonia, but a 3 day course of azithromycin may increase patient compliance.