Swainston Harrison Tracy, Keam Susan J
Wolters Kluwer Health/ Adis, Auckland, New Zealand.
Drugs. 2007;67(5):773-92. doi: 10.2165/00003495-200767050-00010.
Azithromycin is a macrolide antibacterial agent. The novel microspheres oral extended-release formulation (Zmax) is the first antibacterial drug approved in the US for administration as a single dose in adult patients with mild to moderate acute bacterial sinusitis (ABS) or community-acquired pneumonia (CAP). It has a broad spectrum of in vitro antibacterial activity against Gram-positive, Gram-negative and atypical pathogens that cause ABS and CAP infections (including Streptococcus pneumoniae), and achieves good tissue penetration. Azithromycin extended release is an effective and generally well tolerated treatment in patients with ABS or CAP. The clinical cure rates of a single 2.0 g dose of azithromycin extended release were noninferior to those obtained with a 10-day regimen of levofloxacin in patients with ABS, and with 7-day regimens of clarithromycin extended release or levofloxacin in patients with CAP. With a pharmacodynamic and pharmacokinetic profile well suited to administration as a single-dose regimen that may offer the advantage of improved compliance and convenience compared with once-daily longer-course regimens, azithromycin extended release is a new option in the empirical treatment of adult patients with mild or moderate ABS or CAP in the US.
阿奇霉素是一种大环内酯类抗菌剂。新型微球口服缓释制剂(Zmax)是美国批准的首个用于治疗轻度至中度急性细菌性鼻窦炎(ABS)或社区获得性肺炎(CAP)成人患者的单剂量抗菌药物。它对引起ABS和CAP感染的革兰氏阳性、革兰氏阴性和非典型病原体(包括肺炎链球菌)具有广泛的体外抗菌活性,并能实现良好的组织渗透。阿奇霉素缓释制剂对ABS或CAP患者是一种有效且一般耐受性良好的治疗方法。单剂量2.0 g阿奇霉素缓释制剂的临床治愈率在ABS患者中不劣于10天左氧氟沙星治疗方案,在CAP患者中不劣于7天克拉霉素缓释制剂或左氧氟沙星治疗方案。阿奇霉素缓释制剂的药效学和药代动力学特性非常适合单剂量给药方案,与每日一次的较长疗程方案相比,可能具有提高依从性和便利性的优势,是美国轻度或中度ABS或CAP成人患者经验性治疗的新选择。