Author/Editor		Sočan, Maja
Title		Zdravljenje atipične pljučnice z azitromicinom - primerjava 3-dnevnega in 5-dnevnega terapevtskega režima
Translated title		Treatment of atypical pneumonia with azithromycin - comparison of five-day and three-day courses
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 65, št. 8
Publication year		1996
Volume		str. 439-42
Language		slo
Abstract		Bckground. The efficacy of a five-day regimen consisting of 500 mg in a single dose on the first day followed by 250 mg once daily for four consecutive days was compared with that of a three-day course of azithromycin given in single daily doses of 500 mg in the treatment of atypical pneumonia. Patients and methods. Adult patients (older than 15 years) hospitalized with atypical pneumonia in the years 1990 to 1993, were studied retrospectively. For each patient, the medical history, laboratory data, the results of serological tests, chest radiographs and treatment outcome were reviewed. Results. Out of 148 patients with atypical pneumonia, 40 were treated with azithromycin for five days (group 1) and 41 for three days (group 2). The patients of group 1 and 2 did not differ in their clinical presentation and laboratory data (chi-square test). The success rate in group 1 was 80 %. The pathogen was identified in 15 patients. A favourable clinical response was observed in all seven patients with Chlamydia psittaci, Mycoplasma pneumoniae (two patients) and Chlamydia pneumoniae (one patient) pneumonia. Eight patients did not respond to treatment: five had significant complement fixing antibody titres to adenovirus and in three the etiology was unknown. The success rate in group 2 was 88 % (36 patients). The serological tests in group 2 were diagnostic in 18 patients: six were infected with Mycoplasma pneumoniae, five with Chlamydia psittaci, two with Coxiella burnetii and Chlamydia pneumoniae and three with adenovirus. Azithromycin was ineffective in all three patients with adenoviral pneumonia, in one patient with Q fever, and one patient with no identified pathogen. Conclusion. Azithromycin is equally effective in treatment of atypical pneumonia in adult patients if given for three days of for five days to the same total dose.
Summary		Izhodišča. Primerjali smo učinkovitost petdnevnega režima azitromicina (500 mg v enkratnem odmerku, nato 250 mg enkrat dnevno naslednje štiri dni) s tridnevnim režimom (500 mg enkrat dnevno tri dni) za zdravljenje atipične pljučnice. Bolniki in metode. Retrospektivna študija je obsegala odrasle bolnike (starejše od 15 let), hospitalizirane med l. 1990-1993 zaradi atipične pljučnice. Zbrali smo klinične in laboratorijske podatke, rezultate seroloških preiskav, izvid rentgenograma prsnih organov in izhod bolezni. Rezultati. od 148 bolnikov, zdralvjenih zaradi atipične pljučnice, jih je 40 sprejemalo azitromicin pet dni (skupina 1) in 41 tri dni (skupina 2). Skupini se nista razlikovali glede na zbrane klinične podatke in podatke laboratorijskih preiskav (test hi-kvadrat). Uspešnost zdravljenja v prvi skupini je bila 80 %. Povzročitelja smo identificirali pri 15 bolnikih. Ugoden kliničen odgovor je imelo vseh sedem bolnikov s pljučnico, ki jo je povzročila Chlamydia pneumoniae ( en bolnik). Osem bolnikov je bilo neuspešno zdravljenih: pet bolnikov je imelo značilne titre protiteles za adenovirus, pri treh neuspečno zdravljenih bolnikih etiologije nismo pojasnili. Uspešno zdravljenje bolnikov v drugi skupini je bilo 36 (88 %). Serološki testi so bili diagnostični pri 18 bolnikih: pri šestih je bil vzrok pljučnice Mycoplasma pneumoniae, pri petih Chlamydia posittaci, po dva bolnika sta bila okužena s Coxiello burnetti oziroma Chlamydio pneumoniae in trije z adenovirusom. Azitromicin je bil neuspešen pri vseh treh bolnikih z adenovirusno pljučnico, pri enem bolniku z vročico Q, pri enem bolniku povzročitelja nismo ugotovili. Zaključek. Petdnevni in tridnevni režim azitromicina v enakem skupnem odmerku sta enako uspešna za zdravljenje atipične pljučnice odraslih bolnikov.
Descriptors		PNEUMONIA AZITHROMYCIN TIME FACTORS TREATMENT OUTCOME