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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
Authors: Rubio, Fernando Gongora [UNIFESP]
Cunha, Clovis A.
Lundgren, Fernando L. C.
Lima, Maria P. J. S.
Teixeira, Paulo J. Z.
Oliveira, Julio C. A.
Golin, Valdir
Mattos, Waldo L. L. D.
Maehlmann, Herbert K.
Moreira, Edson D.
Jardim, José Roberto [UNIFESP]
Silva, Rodney L. F.
Silva, Patricia H. B.
Nossa Senhora Gracas Hosp
Otavia Freitas Gen Hosp
Catholic Univ
Irmandade Santa Casa Miseriocordia Porto Alegre
Univ Fed Juiz de Fora
Irmandade Santa Casa Miseriocordia
Nossa Senhora Conceicao Hosp
Gen Hosp Itapecerica Serra OSS Seconci
Gen Hosp Roberto Santos
Universidade Federal de São Paulo (UNIFESP)
Univ Fed Parana
Sanatorinhos Hosp OSS Acao Comunitaria
Keywords: community acquired infections
anti-bacterial agents
macrolide ketolides
Issue Date: 1-Jun-2008
Publisher: Contexto
Citation: Brazilian Journal of Infectious Diseases. Salvador: Contexto, v. 12, n. 3, p. 202-209, 2008.
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 (500mg/day) and IVC (1g/day) for 2 to 5 days, followed by AO (500mg/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% (CI(95): 88.9% - 100%) reported cure or clinical improvement; at the end of the study, that figure was 88.9% (CI(95): 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.
ISSN: 1413-8670
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