Azithromycin versus erythromycin in the treatment of paediatric community-acquired pneumonia

A total of 162 patients affected by acute pneumonia were enrolled in a multicentre trial to compare the efficacy of a three-day course of azithromycin (AZM) 10 mg/kg/day once daily with erythromycin (ERM) 50 mg/kg/day two or three times daily for 10 days. One hundred and fifty patients (AZM = 79, ERM = 71) were evaluable. Clinical response at Day 5 ± 2 after baseline control showed a clinical cure rate significantly higher in the AZM-treated group than in the ERM group (2/69 (2.9%) vs. 18/75 (24%), p <0.001). At Day 10 ± 2, the number of cured patients were 75/78 (96%) in the AZM group and 60/67 (90%) in the ERM group. Cure rates at Day 30 ± 2 were 100% and 97% out of a total of 34 and 33 evaluable patients, respectively. Clinical signs and symptoms showed a rapid remission in both groups at Day 5 ± 2, with a more rapid response for malaise, shivering, cough and vomiting in the AZM group. Of the 150 evaluable patients, two AZM-treated patients (2.5%) experienced side effects of vomiting and diarrhoea. The subject with vomiting discontinued the therapy. In the ERM group six patients experienced side effects - mainly gastrointestinal of a mild-to-moderate degree - and among these four discontinued the treatment. Another three patients discontinued the therapy due to lack of efficacy of the drug. The results of this study confirm the effectiveness of a three-day course of AZM in children affected by community-acquired pneumonia and indicate that a faster cure rate may be achieved by this regimen.