Active Ingredients: Azithromycin
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Clinical efficacy is reported from a randomized trial of azithromycin compared to cefuroxime with or without erythromycin. Male and female patients who were at least 16 years of age and who had clinical and radiographic documentation of CAP that necessitated hospitalization and initial i.
Radiographic diagnosis required the appearance within 48 h of the beginning of therapy of a new pulmonary infiltrate s that was not attributable to another etiology. Written informed consent was obtained from all patients, and the institutional review board at each participating medical center approved the study.
The azithromycin regimen in each study consisted of 500 mg given i. The comparative study was a multicenter, parallel-group, randomized, open-label trial of 202 patients receiving azithromycin compared to 201 patients treated with cefuroxime at 750 mg i.
For cefuroxime recipients with suspected pneumonia due to Mycoplasma, Legionella, or Chlamydia, erythromycin given at 500 mg orally four times a day or erythromycin lactobionate given at 500 mg to 1 g i.
The noncomparative trial was a multicenter, open-label study of i. In both trials, investigators made decisions about the time of switch to oral therapy and the total treatment duration on the basis of the patient's clinical response.
Clinical evaluation of response was based on resolution or improvement of clinical and laboratory signs of infection, such as defervescence, normalization of leukocytosis, disappearance of or diminution in the level of purulent sputum production, stabilization of general physical condition, and radiographic resolution of lung infiltrates.
Patients were assessed at the baseline, day 3, every 5 to 7 days during treatment, 10 to 14 days posttherapy, and 4 to 6 weeks posttherapy.
A chest X ray was obtained at the baseline and at the main clinical evaluation time points. The location and extent of lung involvement e. Response criteria. The primary efficacy measure was clinical outcome, which was determined 10 to 14 days posttherapy.
The clinical responses at this time were classified as follows: cure, complete resolution of all signs and symptoms of pneumonia and improvement or resolution of chest X-ray findings; improvement, improvement or resolution of all radiographic findings with incomplete resolution of all signs and symptoms of pneumonia; and failure, persistence or progression of signs and symptoms after 3 days of therapy, development of new findings consistent with active infection, persistence or progression of radiographic findings, death due to pneumonia, or inability to complete the study because of pneumonia-related adverse events.
At 4 to 6 weeks posttherapy, response was classified as cure or failure. Sample size considerations. Patients evaluable for efficacy.
In the comparative trial, inferences about clinical cure rates were based primarily on the group of clinically evaluable patients. A patient evaluable for clinical outcome was defined as a patient who had confirmed diagnosis of pneumonia, whose clinical outcome was determined at either the 10- to 14-day or the 4- to 6-week visit, and who had received at least 5 days of treatment.
Patients with clinical failures were considered evaluable after only 3 days of treatment regardless of treatment group. An intent-to-treat analysis was also performed for patients who received one dose of medication and for whom clinical evaluations were performed at either 10 to 14 days or 4 to 6 weeks.
Microbiologic assessments.Yelp Reviews Azithromycin dosage for gonorrhea It is an antibiotic that has.
Cultures of respiratory tract secretions were done at the baseline and, if samples were obtainable, on day 3, every 5 to 7 days during treatment, and 10 to 14 days and 4 to 6 weeks posttherapy, as well as when clinically indicated.
This can cause an acute decline in GFR of more than 15 percent from baseline with proportional elevations in serum creatinine within the first week of initiating therapy.
In most patients, ACE inhibitors and ARBs can be continued safely if the rise in serum creatinine is less than 30 percent. Typically, the level will return to baseline in four to six weeks.