Brion J P, Sedallian A, Le Noc P, Briffod J, Micoud M
Association pour la Promotion et la Recherche en Information Médicale, Annecy.
Pathol Biol (Paris). 1990 Jun;38(5 ( Pt 2)):521-5.
In an open, multicenter randomized clinical trial on patients with acute pneumonia, 5-day therapy using a new oral macrolide antibiotic, azithromycin (Az), was compared with standard 10-day therapy using another macrolide, josamycin (J). Eighty-nine patients were treated (46 Az, 43 J); both groups were comparable, except in terms of the sex ratios. The causative agent was determined in 31 cases; streptococcal pneumonia was the most common diagnosis (48%). Cure rates were 93% for J and 80% for Az (p greater than 0.30), as judged by a fall in body temperature and an improvement in clinical condition and in radiographic findings. Among 6 failures, there were 4 cases of empyema (1 J, 3 Az). Of 6 deaths, 2 were pneumonia-dependent (1 J and 1 Az, Haemophilus and Streptococcus pneumoniae, respectively). We conclude that 5-day Az is as effective as 10-day J and that such short-course therapy is an advantage in the treatment of pneumonia caused by macrolide susceptible pathogens.
在一项针对急性肺炎患者的开放性、多中心随机临床试验中，将使用新型口服大环内酯类抗生素阿奇霉素（Az）的5天疗程与使用另一种大环内酯类抗生素交沙霉素（J）的标准10天疗程进行了比较。共治疗了89例患者（46例使用Az，43例使用J）；除性别比例外，两组具有可比性。在31例病例中确定了病原体；链球菌性肺炎是最常见的诊断（48%）。根据体温下降、临床状况和影像学表现的改善情况判断，J组的治愈率为93%，Az组为80%（p>0.30）。在6例治疗失败的病例中，有4例为脓胸（1例使用J，3例使用Az）。在6例死亡病例中，2例与肺炎相关（分别为1例使用J和1例使用Az，病原体分别为嗜血杆菌和肺炎链球菌）。我们得出结论，5天的Az疗程与10天的J疗程效果相同，且这种短疗程治疗在治疗由大环内酯类敏感病原体引起的肺炎方面具有优势。
