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Efficacy and safety of a 3-day azithromycin treatment compared to with a 7-day amoxicillin clavulanate treatment in the treatment of adult patients with community-acquired pneumonia

An open randomized study involved 267 ambulatory patients with community-acquired pneumonia clinically diagnosed and confirmed by risk class I or II radiology when assessed on the Fine scale. One group of patients (n = 136) received 1 g of azithromycin 1 time per day for 3 days, the second (n = 131) received 875/125 mg of amoxicillin / clavulanate 2 times per day for 7 days. During culture, PCR or serological studies, the causative agent of pneumonia was identified in 60 of 136 (58.8%) patients in the 1st group and in 61 of 131 patients (62.9%) in the 2nd group group. The clinical efficacy of the treatment, evaluated from the 8th to the 12th day since the start of treatment, was observed in 126 of 136 (92.6%) patients on azithromycin and 122 of 131 (93.1%) patients on amoxicillin / clavulanate.

During the follow-up visit (22-26 days after the start of treatment), none of the patients had a relapse of the disease. Bacteriological eradication at the end of treatment was observed in 32 of 35 patients (91.4%) treated with azithromycin and 30 of 33 (90.9%) treated with amoxicillin / clavulanate.

Adverse events were observed in 34 of 136 patients (25%) on azithromycin and in 22 of 132 (16.7%) treated with amoxicillin / clavulanate, and were mainly represented by gastrointestinal symptoms.

Thus, in the treatment of community-acquired pneumonia in adult patients, azithromycin, administered at a dose of 1 g once a day for 3 days, is as effective as amoxicillin / clavulanate at a dose of 875 / 125 mg 2 times a day for 7 days.