Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate

Pediatr Infect Dis J. 1995 Jun;14(6):471-7. doi: 10.1097/00006454-199506000-00002.

Abstract

We evaluated 260 previously healthy children ages 3 through 12 years who had clinical signs and symptoms of pneumonia, radiographically confirmed. Patients were randomized 1:1 to a 10-day course of either clarithromycin suspension 15 mg/kg/day divided twice a day or erythromycin suspension 40 mg/kg/day divided twice a day or three times a day. Evidence of infection with Chlamydia pneumoniae was detected in 28% (74) of patients: 13% (34) by nasopharyngeal culture and 18% (48) by serology with the microimmunofluorescence assay. Evidence of infection with Mycoplasma pneumoniae was detected in 27% (69) of patients: 20% (53) by nasopharyngeal culture or polymerase chain reaction and 17% (44) by serology with the use of enzyme-linked immunosorbent assay. Serologic confirmation of infection was observed in 23% (8) and 53% (28) of patients with bacteriologically detected C. pneumoniae and M. pneumoniae, respectively. Treatment with clarithromycin vs. erythromycin, respectively, yielded the following outcomes: clinical success 98% (121 of 124) vs. 95% (105 of 110); radiologic success 98% (109 of 111) vs. 94% (92 of 110); and eradication by pathogen, C. pneumoniae 79% (15 of 19) vs. 86% (12 of 14) and M. pneumoniae 100% (9 of 9) vs. 100% (4 of 4). Adverse events were primarily gastrointestinal occurring in almost one-fourth of patients in both groups, and were mild to moderate in severity. Clarithromycin and erythromycin were similarly effective and safe for the treatment of radiographically proved, community-acquired pneumonia in children older than 2 years old.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Chlamydia Infections / diagnosis
  • Chlamydia Infections / drug therapy*
  • Chlamydia Infections / physiopathology
  • Chlamydophila pneumoniae / drug effects*
  • Clarithromycin / administration & dosage
  • Clarithromycin / adverse effects
  • Clarithromycin / therapeutic use*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Drug Administration Schedule
  • Erythromycin Ethylsuccinate / administration & dosage
  • Erythromycin Ethylsuccinate / adverse effects
  • Erythromycin Ethylsuccinate / therapeutic use*
  • Female
  • Humans
  • Male
  • Pneumonia, Mycoplasma / diagnosis
  • Pneumonia, Mycoplasma / drug therapy*
  • Pneumonia, Mycoplasma / physiopathology
  • Prospective Studies
  • Treatment Outcome

Substances

  • Erythromycin Ethylsuccinate
  • Clarithromycin