title: Effectiveness of azithromycin in aspiration pneumonia: a prospective observational study.
abstract: BACKGROUND
  Aspiration pneumonia is an urgent health concern with high mortality and long hospitalization in industrialized and aging countries. However, there is no information about the effectiveness of azithromycin (AZM) for the treatment of aspiration pneumonia. This study investigated if AZM is effective for the treatment of aspiration pneumonia.
  
  
  METHODS
  Patients with aspiration pneumonia with no risk of multidrug-resistant pathogens were included in this prospective study at Kishiwada City Hospital from December 2011 to June 2013. Patients were divided into the ampicillin/sulbactam (ABPC/SBT) and AZM (intravenous injection) groups. The success rates of 1(st)-line antibiotic therapy, mortality, length of hospital stay, and total antibiotic costs were compared.
  
  
  RESULTS
  There were 81 and 36 patients in the ABPC/SBT and AZM groups, respectively. There was no significant difference in the success rate of 1(st)-line antibiotics between the groups (74.1% vs. 75.0%, respectively, P = 1.000). Mortality and hospitalization periods did not differ between the 2 groups (11.1% vs. 8.3%, P = 0.753, and 22.3 ± 7.3 days vs. 20.5 ± 8.1 days, P = 0.654, respectively). However, the total antibiotic costs were significantly lower in the AZM group than the ABPC/SBT group (2.19 ± 1.65 × 10,000 yen vs. 2.94 ± 1.67 × 10,000 yen, respectively, P = 0.034). The febrile period of the ABPC/SBT group was significantly shorter than that of the AZM group (P = 0.025).
  
  
  CONCLUSIONS
  In this small prospective non-randomized observational study, we found no statistically significant differences in mortality or antibiotic failure in patients receiving AZM compared to ABPC/SBT for the treatment of patients with aspiration pneumonia who require hospital admission and have no risk of drug-resistant pathogens. Therefore, AZM may be another first choice of antibiotic treatment for patients with aspiration pneumonia when they have no risk of multidrug-resistant pathogens.
authors.affiliation: Respiratory Disease Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan. marumo@kuhp.kyoto-u.ac.jp.|Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan. marumo@kuhp.kyoto-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Marumo
authors.affiliation: Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan. terandesu@yahoo.co.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Teranishi
authors.affiliation: Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan. yuichi10780@yahoo.co.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Higami
authors.affiliation: Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan. k.yoshiyoshiyoshi@gmail.com.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Koshimo
authors.affiliation: Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan. h.kiyokawa@gmail.com.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kiyokawa
authors.affiliation: Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan. kch-43@kishiwada-hospital.com.
authors.forename: Motokazu
authors.initials: M
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000188:drug therapy*; D011446:Prospective Studies; D013407:Sulbactam / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; C035444:sultamicillin; D000667:Ampicillin; D017963:Azithromycin; D013407:Sulbactam