[Treatment for Legionnaires' disease. Macrolides or quinolones?].
BACKGROUND
Macrolides and fluoroquinolones are the recommended treatment for Legionnaires' disease. The aim of our study was to analyze the clinical efficacy of clarithromycin, azithromycin and levofloxacin in patients with Legionnaires' disease.


METHODS
Prospective, observational study involving all adult patients with Legionella pneumophila pneumonia attended at Hospital Universitario Vall d'Hebron (Barcelona, Spain) from January 2001 to December 2004. Duration of fever, length of hospital stay and mortality were compared among 52 patients treated with clarithromycin, 43 with azithromycin and 18 with levofloxacin.


RESULTS
The proportion of patients with risk factors for Legionnaires' disease, the initial severity of the pneumonia and the number of patients who required intensive care unit admission were similar in patients treated with clarithromycin, azithromycin and levofloxacin. In-hospital mortality was 5.3%. There were no significant differences in fever duration, length of hospital stay or mortality among the 3 groups of patients.


CONCLUSIONS
In our experience, clarithromycin, azithromycin and levofloxacin were all efficacious for the treatment of Legionnaires' disease.
Falcó
Vicenç
V
Servicios de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, España. vfalco@vhebron.net
Molina
Israel
I
Juste
Concha
C
Crespo
Manel
M
Almirante
Benito
B
Pigrau
Carles
C
Ferrer
Adelaida
A
Bravo
Carlos
C
Palomar
Mercedes
M
Pahissa
Albert
A
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000652:urine; D017963:Azithromycin / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D003422:Critical Care; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D004341:Drug Evaluation; D005260:Female; D005334:Fever / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D016867:Immunocompromised Host; D016952:Legionella pneumophila / Q000276:immunology; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D064704:Levofloxacin; D017963:Azithromycin; D015242:Ofloxacin; D017291:Clarithromycin