A Multicenter, Randomized Study Comparing The Efficacy And Safety Of Intravenous And/or Oral Levofloxacin Versus Ceftriaxone And/or Cefuroxime Axetil In Treatment Of Adults With Community-acquired Pneumonia
activity; antibacterial; antibiotics; chlamydia-pneumoniae; ciprofloxacin; dr-3355; invitro activities; Microbiology; optically-active ofloxacin; Pharmacology & Pharmacy; respiratory-tract infections; therapy
File T M; Segreti J; Dunbar L; Player R; Kohler R; Williams R R; Kojak C; Rubin A
Antimicrobial Agents and Chemotherapy
1997
1997-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1128/aac.41.9.1965" target="_blank" rel="noreferrer noopener">10.1128/aac.41.9.1965</a>
Community-acquired pneumonia in adults: Guidelines for management
Infectious Diseases; Microbiology; united-states; Immunology; polymerase chain-reaction; resistant streptococcus-pneumoniae; legionnaires-disease; chlamydia-pneumoniae; aspiration; diagnostic fiberoptic bronchoscopy; hantavirus pulmonary syndrome; pneumococcal polysaccharide vaccine; pneumocystis-carinii pneumonia; transtracheal
This is part of the series of practice guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. The purpose of this guideline is to provide assistance to clinicians in the diagnosis and treatment of community-acquired pneumonia, The targeted providers are internists and family practitioners. The targeted groups are immunocompetent adult patients. Criteria are specified for determining whether the inpatient or outpatient setting is appropriate for treatment. Differences from other guidelines written on this topic include use of laboratory criteria for diagnosis and approach to antimicrobial therapy. Panel members and consultants are experts in adult infectious diseases. The guidelines are evidence based where possible. A standard ranking system is used for the strength of the recommendations and the quality of the evidence cited in the literature reviewed. The document has been subjected to external review by peer reviewers as well as by the Practice Guidelines Committee and was approved by the IDSA Council. An executive summary and tables highlight the major recommendations. The guidelines will be listed on the IDSA home page at http://www.idsociety.org.
Bartlett J G; Breiman R F; Mandell L A; File T M
Clinical Infectious Diseases
1998
1998-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1086/513953" target="_blank" rel="noreferrer noopener">10.1086/513953</a>
Azithromycin vs cefuroxime plus erythromycin for empirical treatment of community-acquired pneumonia in hospitalized patients - A prospective, randomized, multicenter trial
adults; chlamydia-pneumoniae; diagnosis; epidemiology; etiology; General & Internal Medicine; guidelines; in-vitro activities; management; resistant streptococcus-pneumoniae; therapy
Objective: To compare the efficacy and safety of azithromycin dihydrate monotherapy with those of a combination of cefuroxime axetil plus erythromycin as empirical therapy for community-acquired pneumonia in hospitalized patients. Methods: Patients were enrolled in a prospective, randomized, multicenter study. The standard therapy of cefuroxime plus erythromycin was consistent with the American Thoracic Society, Canadian Community-Acquired Pneumonia Consensus Group, and Infectious Disease Society of America consensus guidelines. The doses were intravenous azithromycin (500 mg once daily) followed by oral azithromycin (500 mg once daily), intravenous cefuroxime (750 mg every 8 hours), followed by oral cefuroxime axetil (500 mg twice daily), and erythromycin (500-1000 mg) intravenously or orally every 6 hours. Randomization was stratified by severity of illness and age. Patients who were immunosuppressed or residing in nursing homes were excluded. Results: Data from 145 patients (67 received azithromycin and 78 received cefuroxime plus erythromycin) were evaluable. Streptococcus pneumoniae and Haemophilus influenzae were isolated in 19% (28/145) and 13% (19/145), respectively. The atypical pathogens accounted for 33% (48/145) of the etiologic diagnoses; Legionella pneumophila, Chlamydia pneumoniae, and Mycoplasma pneumoniae were identified in 14% (20/ 145), 10%;, (15/145), and 9% (13/145), respectively. Clinical cure was achieved in 91% (61/67) of the patients in the azithromycin group and 91% (71/78) in the cefuroxime plus erythromycin group. Adverse events (intravenous catheter site reactions, gastrointestinal tract disturbances) were significantly more common in patients who received cefuroxime plus erythromycin (49% [30/78]) than in patients who received azithromycin (12% [8/67]) (P<.001). Conclusions: Treatment with azithromycin was as effective as cefuroxime plus erythromycin in the empirical management of community-acquired pneumonia in immunocompetent patients who were hospitalized. Azithromycin was well tolerated.
Vergis E N; Indorf A; File T M; Phillips J; Bates J; Tan J; Sarosi G A; Grayston J T; Summersgill J; Yu V L
Archives of Internal Medicine
2000
2000-05
Journal Article
<a href="http://doi.org/10.1001/archinte.160.9.1294" target="_blank" rel="noreferrer noopener">10.1001/archinte.160.9.1294</a>