title: [Macrolides in the treatment of children with Mediterranean spotted fever].
abstract: Till now there is not a gold standard therapy for Mediterranean spotted fever (MSF) in children. Standard treatment for MSF is the administration of tetracycline or chloramphenicol, however both these drugs can cause significant adverse effects in children (tetracyclines can cause staining of teeth, chloramphenicol severe hematological adverse events such as aplastic anemia, gray baby syndrome and hemolytic anemia in patients with the Mediterranean form of G6PD deficiency). We conducted two randomized clinical trials; the first compared clarithromycin versus chloramphenicol: mean time to defervescence was 36.7 +/- 18.1 h in the clarithromycin group and 47.1+/- 21.9 h in the chloramphenicol group (P= 0.047). The second trial compared clarithromycin versus azithromycin and did not show any statistically significant difference: mean time to defervescence was 46.2 +/- 36.4 h in the clarithromycin group and 39.3 +/- 31.3 h in the azithromycin group (P= 0.34). On the basis of these studies we think that clarithromycin and azithromycin could constitute an acceptable alternative to chloramphenicol and to tetracyclines for the treatment of MSF in children
authors.affiliation: Istituto di Patoligia Infettiva e Virologia, Universita degli Studi di Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cascio
authors.forename: Claudia
authors.initials: C
authors.lastname: Colomba
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use; D001907:Boutonneuse Fever / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012802:Sicily / Q000453:epidemiology; D013754:Tetracyclines / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D013754:Tetracyclines; D002701:Chloramphenicol; D017963:Azithromycin; D017291:Clarithromycin
vernacular_title: I macrolidi nella terapia della febbre bottonosa del Mediterraneo in età pediatrica.