0
Clinical Investigations: INFECTION |

Fluoroquinolones vs Macrolides in the Treatment of Legionnaires Disease*

Miquel Sabrià, MD, PhD; María Luisa Pedro-Botet, MD, PhD; Joaquín Gómez, MD, PhD; Jorge Roig, MD, PhD; Blanca Vilaseca, MD; Nieves Sopena, MD, PhD; Victor Baños, MD, PhD; for the Legionnaires Disease Therapy Group
Author and Funding Information

Affiliations: *From the Infectious Diseases Unit (Drs. Sabrià, Pedro-Botet, Vilaseca, and Sopena), Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; Infectious Diseases and Pneumology Units (Drs. Gómez and Baños), Hospital Virgen de la Arriaxaca, Universidad de Murcia, Murcia, Spain; and Pulmonary Division (Dr. Roig), Hospital Nostra Senyora de Meritxell, Escaldes, Principality of Andorra.,  A list of participants is given in the Appendix.

Correspondence to: Miquel Sabrià, MD, PhD, Unitat de Malalties Infeccioses, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Badalona 08916, Barcelona, Spain; e-mail: msabria@ns.hugtip.scs.es



Chest. 2005;128(3):1401-1405. doi:10.1378/chest.128.3.1401
Text Size: A A A
Published online

Background: Erythromycin has been the treatment of choice for Legionnaires disease (LD). However, treatment failure and experimental evidence of its bacteriostatic effect have led to evaluation of new drugs such as fluoroquinolones. This study compared the evolution of patients with LD treated with macrolides and fluoroquinolones.

Methods: A prospective observational study was performed, and 130 patients from three centers were included. Diagnoses were made using Legionella urinary antigen assay in all patients. Patients receiving any antibiotic > 36 h before starting the study therapy were excluded. Group 1 included 76 patients who received macrolides (33 patients with erythromycin and 43 patients with clarithromycin), and group 2 included 54 patients treated with fluoroquinolones (50 patients with levofloxacin and 4 patients with ofloxacin).

Results: No significant differences were seen between the two groups regarding age, sex, smoking, alcohol intake, underlying diseases, or community/hospital acquisition. The time from onset of LD symptoms until the initiation of antibiotic treatment was 78.5 h and 92.7 h in groups 1 and 2, respectively (p = 0.1). Time to apyrexia was significantly longer in the macrolide group (77.1 h vs 48 h for groups 1 and 2, respectively; p = 0.000). There were no differences according to radiology, clinical complications, or mortality. Nevertheless, a trend to a longer hospital stay was observed in the macrolide group (9.9 days vs 7.6 days in groups 1 and 2, respectively; p = 0.09).

Conclusions: Fluoroquinolones were as effective as erythromycin in the treatment of LD. It is of note that time to apyrexia was significantly shorter and hospital stay tended to be shorter in patients receiving fluoroquinolones.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
Guidelines
Mycobacterial infections.
New York State Department of Health | 6/20/2008
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543