Azithromycin is a recently developed antibacterial agent belonging to a new class of azalide antibiotics with an improved spectrum of activity against gram-negative organisms, most notably Haemophilus influenzae. Azithromycin also has good in vitro activity against most other common respiratory pathogens, including Moraxella catarrhalis, Streptococcus pneumoniae, Mycoplasma pneumoniae, and Chlamydia species. The purpose of this multicenter study was to compare the efficacy and safety of once-daily azithromycin (for 3 days) with josamycin (given thrice daily over 7 days) in children with community-acquired pneumonia. One hundred ten patients with pneumonia from 19 university and hospital pediatric departments were enrolled in the study. Clinical response to therapy, which was classified as cure, improvement, or failure, was assessed at day 4 and day 8 of treatment. Azithromycin was significantly (P <0.05) more effective than josamycin in reducing fever and in improving total clinical score at visit 2 (day 4). The two treatments were equivalent in terms of the number of patients considered to be cured and improved at visit 3 (day 8). Three patients in each group suffered from side effects. All side effects spontaneously resolved. The results of this study show that a 3-day course of azithromycin is as effective as a 7-day course of josamycin, with a faster clinical response. Both treatments were well tolerated.
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