An open, randomized, comparative study of clarithromycin and erythromycin in the treatment of children with community-acquired pneumonia.
OBJECTIVE
This study aimed to evaluate the efficacy and safety of clarithromycin and erythromycin in the treatment of community-acquired pneumonia in children.


METHODS
Children with community-acquired pneumonia were randomly assigned to receive 10-day regimens of either clarithromycin 15 mg/kg/day, twice a day, or erythromycin 30-50 mg/kg/day, four times daily.


RESULTS
A total of 97 children entered this study, including 26 with Mycoplasma pneumoniae infection, 15 with Chlamydia pneumoniae infection, and 6 with mixed mycoplasma and chlamydia infections. Fifty and 47 children received clarithromycin and erythromycin treatment, respectively. Three children withdrew from the study because the identified pathogens were resistant to the study drugs. All 47 children with mycoplasma or chlamydia infection were cured clinically. Delayed defervescence, defined as a fever lasting for more than 72 h after treatment, was observed in 4 of 22 clarithromycin-treated children (18%) and in 3 of 15 erythromycin-treated children (20%) [p>0.05]. Gastrointestinal side effects, including vomiting, abdominal pain and diarrhea, were observed in 3 of 50 children (6%) receiving clarithromycin and in 11 of 49 children (22%) receiving erythromycin (p=0.039). Excluding children with abnormal pretreatment liver function, abnormal liver function after treatment was observed in only one child, treated with erythromycin. Post-treatment eosinophil and platelet counts were significantly elevated after treatment in both groups.


CONCLUSIONS
Clarithromycin showed efficacy equivalent to erythromycin for the treatment of mycoplasma or chlamydia pneumonia in children. However, the tolerability of clarithromycin was superior to that of erythromycin.
Lee
Ping-Ing
PI
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. pinging@ntumc.org
Wu
Mei-Hwan
MH
Huang
Li-Min
LM
Chen
Jong-Min
JM
Lee
Chin-Yun
CY
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000188:drug therapy; D017291:Clarithromycin / Q000008:administration & dosage* / Q000009:adverse effects; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions; D004917:Erythromycin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009175:Mycoplasma Infections / Q000188:drug therapy; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D017291:Clarithromycin