title: Intravenous azithromycin plus ceftriaxone followed by oral azithromycin for the treatment of inpatients with community-acquired pneumonia: an open-label, non-comparative multicenter trial.
abstract: Community-Acquired Pneumonia (CAP) is a major public health problem. In Brazil it has been estimated that 2,000,000 people are affected by CAP every year. Of those, 780,000 are admitted to hospital, and 30,000 have death as the outcome. This is an open-label, non-comparative study with the purpose of evaluating efficacy, safety, and tolerability levels of IV azithromycin (IVA) and IV ceftriaxone (IVC), followed by oral azithromycin (OA) for the treatment of inpatients with mild to severe CAP. Eighty-six patients (mean age 56.6 +/- 19.8) were administered IVA (500 mg/day) and IVC (1g/day) for 2 to 5 days, followed by AO (500 mg/day) to complete a total of 10 days. At the end of treatment (EOT) and after 30 days (End of Study--EOS) the medication was evaluated clinically, microbiologically and for tolerability levels. Out of the total 86-patient population, 62 (72.1%) completed the study. At the end of treatment, 95.2% (CI95: 88.9% - 100%) reported cure or clinical improvement; at the end of the study, that figure was 88.9% (CI95: 74.1% - 91.7%). Out of the 86 patients enrolled in the study, 15 were microbiologically evaluable for bacteriological response. Of those, 6 reported pathogen eradication at the end of therapy (40%), and 8 reported presumed eradication (53.3%). At end of study evaluation, 9 patients showed pathogen eradication (50%), and 7 showed presumed eradication (38.89%). Therefore, negative cultures were obtained from 93.3% of the patients at EOT, and from 88.9% at the end of the study. One patient (6.67% of patient population) reported presumed microbiological resistance. At study end, 2 patients (11.11%) still reported undetermined culture. Uncontrollable vomiting and worsening pneumonia condition were reported by 2.3% of patients. Discussion and Conclusion Treatment based on the administration of IV azithromycin associated to ceftriaxone and followed by oral azithromycin proved to be efficacious and well-tolerated in the treatment of Brazilian inpatients with CAP.
authors.affiliation: Hospital de Base of FUNFARME, São José do Rio Preto, SP, Brazil.
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Rubio
authors.forename: Clóvis A
authors.initials: CA
authors.lastname: Cunha
authors.forename: Fernando L C
authors.initials: FL
authors.lastname: Lundgren
authors.forename: Maria P J S
authors.initials: MP
authors.lastname: Lima
authors.forename: Paulo J Z
authors.initials: PJ
authors.lastname: Teixeira
authors.forename: Julio C A
authors.initials: JC
authors.lastname: Oliveira
authors.forename: Valdir
authors.initials: V
authors.lastname: Golin
authors.forename: Waldo L L D
authors.initials: WL
authors.lastname: Mattos
authors.forename: Herbert K
authors.initials: HK
authors.lastname: Mählmann
authors.forename: Edson D
authors.initials: ED
authors.lastname: Moreira
authors.forename: Jose R
authors.initials: JR
authors.lastname: Jardim
authors.forename: Rodney L F
authors.initials: RL
authors.lastname: Silva
authors.forename: Patricia H B
authors.initials: PH
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017963:Azithromycin / Q000008:administration & dosage* / Q000009:adverse effects; D002443:Ceftriaxone / Q000008:administration & dosage* / Q000009:adverse effects; D017714:Community-Acquired Infections / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D017963:Azithromycin