Retrospective analysis of azithromycin versus fluoroquinolones for the treatment of legionella pneumonia.
BACKGROUND
Legionella is often associated with life-threatening pneumonia that is responsible for significant morbidity and mortality. Fluoroquinolones (FQ) have demonstrated improved clinical outcomes or decreased complications compared with clarithromycin and erythromycin. However, there is limited data comparing outcomes of FQ to azithromycin (AZM), which exhibits better Legionella activity than erythromycin and clarithromycin.


METHODS
This single-center retrospective study compared clinical outcomes of patients with Legionella pneumonia (LP) treated with AZM versus FQ from January 1999 to May 2011.


RESULTS
A total of 41 patients were included in the analysis; 21 received FQ and 20 received AZM. Demographics, comorbidities, and disease severity were similar between groups. Mortality (9.5% vs. 5%, P > 0.99), time to clinical stability (15.89 days vs. 10.26 days, P = 0.09), length of hospitalization (19.29 days vs. 11.35 days, P = 0.06), and presentation of any complication (85.7% vs. 90%, P > 0.99) were similar between the FQ and AZM groups, respectively.


CONCLUSIONS
Azithromycin appears to have clinical efficacy similar to FQ for the treatment of Legionella pneumonia.
Jerod L
JL
Nagel
Rachel E
RE
Rarus
Alex W
AW
Crowley
Cesar
C
Alaniz
Legionella pneumophilia; Legionnaires’ disease; azithromycin; community-acquired pneumonia; levofloxacin; macrolides