ro13-9904 and Chlamydial-Pneumonia

, a common cause of respiratory tract infections, rarely leads to serious conditions. A 13-year-old boy with serologically confirmed

Topics: Adolescent; Ceftriaxone; Chlamydial Pneumonia; Chlamydophila pneumoniae; Clarithromycin; Humans; Immunoglobulin G; Immunoglobulin M; Male; Pericarditis; Sputum

Therapy directed against atypical pathogens in patients with community-acquired pneumonia (CAP) is often recommended. This post-hoc analysis evaluated the effect of addition of a macrolide to ceftaroline fosamil or ceftriaxone treatment in atypical CAP.. Two phase 3, double-blind, comparative safety and efficacy studies of ceftaroline fosamil vs. ceftriaxone, FOCUS 1 and FOCUS 2, enrolled adults with CAP. Only FOCUS 1 included 24-h adjunctive clarithromycin therapy for all patients on day 1. Day 4 and test-of-cure (TOC) outcomes were compared for adjunctive vs. no adjunctive therapy.. Of 1240 enrolled patients, 130 patients with CAP due to atypical pathogens alone were included (FOCUS 1, n = 64; FOCUS 2, n = 66). Among patients infected with Mycoplasma pneumoniae and/or Chlamydophila pneumoniae alone, a higher clinical response rate was observed with clarithromycin plus ceftaroline fosamil or ceftriaxone compared with treatment without additional clarithromycin at day 4 [38/49 (77.6%; FOCUS 1) vs. 24/43 (55.8%; FOCUS 2)], but not at the TOC assessment [42/49 (85.7%; FOCUS 1) vs. 41/43 (95.3%; FOCUS 2)]. In patients infected with Legionella pneumophila alone, a higher clinical response rate with adjunctive clarithromycin therapy was observed at the TOC assessment alone [12/12 (100%; FOCUS 1) vs. 14/19 (73.7%; FOCUS 2)]. The unadjusted odds ratio of a favourable clinical response at day 4 with adjunctive clarithromycin vs. no adjunctive clarithromycin was 2.4 (95% confidence interval 1.1-5.1; P = 0.0299) for all pathogens combined.. These results suggest that empirical antibiotic therapy against atypical pathogens may improve early clinical response rate. This hypothesis is best evaluated in a prospective trial.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Ceftaroline; Ceftriaxone; Cephalosporins; Chlamydial Pneumonia; Chlamydophila pneumoniae; Clinical Trials, Phase III as Topic; Community-Acquired Infections; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Legionella pneumophila; Macrolides; Male; Middle Aged; Mycoplasma pneumoniae; Pneumonia, Bacterial; Pneumonia, Mycoplasma; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome