Zithromax scientific update |
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Clin Infect Dis. 2003 May 15;36(10):1239-45. Epub 2003 May 06.
Sanchez F, Mensa J, Martinez JA, Garcia E, Marco F, Gonzalez J, Marcos MA, Soriano A, Torres A.
Institut Clinic dInfeccions i Immunologia, Hospital Clinic i Provincial de Barcelona, 08026 Barcelona, Spain.
Is azithromycin the first-choice macrolide for treatment of community-acquired pneumonia?
Combination treatment with a beta-lactam plus a macrolide may improve the outcome for elderly patients with community-acquired pneumonia (CAP). The prognoses and mortality rates for elderly patients with CAP who receive ceftriaxone combined with a 3-day course of azithromycin or a 10-day course of clarithromycin were compared in an open-label, prospective study. Of 896 assessable patients, 220 received clarithromycin and 383 received azithromycin. There were no significant differences between groups with regard to the severity score defined by the Pneumonia Patient Outcomes Research Team (PORT) study group; the incidence of bacteremia was also not significantly different. However, for patients treated with azithromycin, the length of hospital stay was shorter (mean+/-SD, 7.4+/-5 vs. 9.4+/-7 days; P<.01) and the mortality rate was lower (3.6% vs. 7.2%; P<.05), compared with those treated with clarithromycin. There might be a difference in the outcome for patients with CAP depending on the macrolide used. A shorter treatment course with azithromycin may result in better compliance with therapy.
Int J STD AIDS. 2004 Apr;15(4):240-2.
Habib AR, Fernando R.
Department of Genitourinary Medicine, New Cross Hospital, Wednesfield Road, Wolverhampton WV10 0QP, UK.
Efficacy of azithromycin 1g single dose in the management of uncomplicated gonorrhoea.
This paper describes the efficacy of azithromycin 1g single dose in the management of uncomplicated gonorrhoea either with or without chlamydial co-infection. Three hundred and one patients were treated for gonorrhoea between January 2000 and June 2001; 226/301 (75.1%) were treated with azithromycin 1g stat dose while the rest were treated with different regimens. Ninety-seven of 301 (32.2%) of all isolated strains were found to be resistant to at least one antibiotic where penicillin constituted the majority (23%). Chlamydial co-infection was found in 38.2% (115/301). Only 73.1% (220/301) attended for a test-of-cure, all but six patients had negative gonorrhoea cultures at their reviews. Among the six failures 3/32 (9.3%) were initially on amoxicillin, 2/170 (1.2%) on azithromycin and 1/22 (4.5%) on ciprofloxacin. Hence, azithromycin stat dose has proved to be a cost-effective treatment for uncomplicated gonorrhoea supported by the increased prevalence of penicillin-resistant organisms, concomitant chlamydial infection and the high failure rate in keeping review appointments.
Int J Dermatol. 2004 Feb;43(2):151-4.
Bakar O, Demircay Z, Gurbuz O.
Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
Therapeutic potential of azithromycin in rosacea.
BACKGROUND: Systemic antibiotics currently used in the treatment of rosacea are sometimes associated with uncomfortable side-effects. Therefore, a need for an effective agent with few side-effects and good patient compliance exists. Azithromycin, a macrolide antibiotic with prolonged mode of action, has recently been found to be an effective alternative in the treatment of inflammatory acne. We planned a study to evaluate the efficacy and safety of azithromycin in rosacea. METHODS: An open-labeled study was performed in a population of 18 patients, with Plewig-Kligman stage 2 rosacea. Patients were given oral azithromycin for 12 weeks in decreasing doses. RESULTS: Fourteen subjects completed the trial. The treatment produced therapeutic benefits with regard to total scores as well as inflammatory lesion scores. At the end of 12 weeks, there was a 75% decrease in total scores (P < 0.001) and an 89% decrease in inflammatory lesion scores compared with basal values. Improvement continued during the 4 weeks after treatment. Adverse effects were minimal and well tolerated in most patients. CONCLUSION: Azithromycin is a promising agent in the treatment of rosacea with its few side-effects and good patient compliance.
Transplantation. 2004 May 15;77(9):1465-7.
Verleden GM, Dupont LJ.
University Hospital Gasthuisberg, Department of Respiratory Medicine and Lung Transplantation Unit, Leuven, Belgium.
Azithromycin therapy for patients with bronchiolitis obliterans syndrome after lung transplantation.
BACKGROUND: Bronchiolitis obliterans syndrome (BOS) is the leading cause of late mortality after lung transplantation. METHODS: We added azithromycin (AZI) (250 mg/day for 5 days, followed by 250 mg every other day) to the current immunosuppressive therapy in eight lung transplant recipients (mean age 36 years) with established BOS in an attempt to prevent further decline of the forced expiratory volume in 1 sec (FEV1). RESULTS: Before the administration of AZI, there was a gradual decline of the FEV1 (-34.4%+/-14.7%) compared with the patients' best postoperative values. Twelve weeks after AZI had been added, there was a significant increase in the FEV1 (+18.3%+/-14.6%, P <0.0001, analysis of variance) with an absolute increase of 328+/-305 mL. This increase persisted in three patients during 9 months of follow-up. CONCLUSIONS: AZI is a promising drug for some patients with BOS after lung transplantation. The exact mechanism of action is unknown at the present time.
Eur Respir J. 2005 Mar;25(3):490-3.
Khalid M, Al Saghir A, Saleemi S, Al Dammas S, Zeitouni M, Al Mobeireek A, Chaudhry N, Sahovic E.
Section of Pulmonary Medicine, Dept of Medicine, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia.
Azithromycin in bronchiolitis obliterans complicating bone marrow transplantation: a preliminary study.
Bronchiolitis obliterans (BO) is a serious noninfectious pulmonary complication following allogeneic bone marrow transplantation (BMT). Azithromycin, a macrolide antibiotic, may have a beneficial effect in BO through its anti-inflammatory effect. The aim of the current study was to investigate the potential effect of azithromycin on pulmonary function tests (PFTs) in BO complicating BMT. PFTs of 153 post-BMT patients were followed; eight patients out of 153 (12%) developed obstructive airway disease on their PFTs, along with characteristic findings of BO on high-resolution computed tomography of the chest. These patients were given azithromycin 500 mg q.d. for 3 days, followed by 250 mg three times a week for 12 weeks. Clinically significant improvements were achieved both in forced vital capacity, where the mean (95% confidence interval) increase reported was 410 mL (0.16-0.65), which was an average improvement of 21.57%, and in the forced expiratory volume in one second, where the mean increase noticed was 280 mL (0.10-0.44), which was an average improvement of 20.58%. In conclusion, the potential role of azithromycin in the treatment of bronchiolitis obliterans is intriguing and it warrants further testing.
Zithromax description...
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Drug category:Antibacterial and antiviral agent
 Zithromax scientific update
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