Azithromycin prophylaxis during a hospital outbreak of Mycoplasma pneumoniae pneumonia.
Outbreaks of Mycoplasma pneumoniae (MP) in closed communities can have a high attack rate and can last several months. Azithromycin chemoprophylaxis has not been evaluated as a means of limiting transmission. This randomized, double-blinded placebo-controlled trial of azithromycin was conducted among asymptomatic hospital employees during an MP outbreak. Oropharyngeal swabs were obtained for detection of MP by polymerase chain reaction, and questionnaires were administered to assess clinical illness. Of the 147 employees who were enrolled, 73 received azithromycin and 74 received placebo. Carriage was similar within and between groups at weeks 1 and 6 (9.6% vs. 6.7% and 10.3% vs. 13.2%, respectively). Four episodes of clinically significant respiratory illness occurred in the azithromycin group versus 16 episodes in the placebo group (protective efficacy, 75%; 95% confidence interval, 28%-91%). Use of azithromycin prophylaxis in asymptomatic persons during an MP outbreak in a closed setting may be of value in reducing clinical illness.
Hyde
T B
TB
Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Gilbert
M
M
Schwartz
S B
SB
Zell
E R
ER
Watt
J P
JP
Thacker
W L
WL
Talkington
D F
DF
Besser
R E
RE
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017963:Azithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D004196:Disease Outbreaks; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification; D009960:Oropharynx / Q000382:microbiology; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission
D000900:Anti-Bacterial Agents; D017963:Azithromycin