J Chemother. 1998 Feb;10(1):64-8.
Treatment of atypical pneumonia with azithromycin: comparison of a 5-day and a 3-day course.

Socan M.

Department of Infectious Diseases, University Medical Center, Ljubljana, Slovenia.

The efficacy of a 5-day regimen consisting of 500 mg in a single dose on the first day followed by 250 mg once daily for 4 consecutive days was compared with that of a 3-day course of azithromycin [Zithromax] given in single daily doses of 500 mg for treatment of atypical pneumonia. Adult patients hospitalized with atypical pneumonia in the years 1990 to 1993 were studied retrospectively. For each patient, the medical history, laboratory data, the results of serological tests, chest radiographs and treatment outcome were reviewed. Out of 148 patients with atypical pneumonia, 40 were treated with azithromycin [Zithromax] for 5 days (Group 1) and 41 for 3 days (Group 2). The success rate in Group 1 was 80% (32 patients). Eight patients did not respond to treatment: 5 had significant complement fixing antibody titers to adenovirus and in 3 the etiology was unknown. The success rate in Group 2 was 88% (36 patients). Azithromycin [Zithromax] was ineffective in all 3 patients with adenoviral pneumonia, in 1 patient with Q fever, and in 1 patient with no identified pathogen. Azithromycin [Zithromax] is equally effective as treatment of atypical pneumonia in adult patients if given for 3 or 5 days at the same total dose.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9531077&dopt=Abstract Zithromax azithromycin




Med J Aust. 2000 Feb 21;172(4):163-6.
A targeted, single-dose azithromycin [Zithromax] strategy for trachoma.

Laming AC, Currie BJ, DiFrancesco M, Taylor HR, Mathews JD.

Royal North Shore Hospital, Sydney, NSW.

OBJECTIVE: To evaluate the impact of treating children with acute trachoma and their contacts with oral azithromycin. DESIGN: Open, uncontrolled, prospective evaluation of a community-based treatment strategy. SETTING: Central Australian semi-desert Aboriginal community (1995-1996). PARTICIPANTS: 216 school- and pre-schoolchildren aged 6 months and up to 15 years. INTERVENTION: All children with acute trachoma and their contacts (co-resident siblings aged between 6 months and 15 years) received single-dose oral azithromycin [Zithromax] suspension (20 mg/kg, to a maximum of 1000 mg). MAIN OUTCOME MEASURE: Prevalence of acute trachoma (World Health Organization trachoma diagnostic criteria). RESULTS: Trachoma prevalence at baseline was 42% (71/169) and 55% (18/33) for schoolchildren and pre-schoolchildren, respectively: 103 schoolchildren and 21 pre-schoolchildren, comprising 77 with follicular trachoma and their 47 contacts, were treated with azithromycin [Zithromax] over an 8-week period. Acute trachoma prevalence in schoolchildren fell to 22% at 6-8 months (P < 0.0001) and was 31% at 12 months (P < 0.05 compared with baseline). Pre-schoolchildren were followed up for 6 months after treatment, and their trachoma prevalence fell from 55% to 25% (P < 0.05). Further treatment was given to children with trachoma at 12 months, and the point prevalence of trachoma for schoolchildren at 24 months was 34%. CONCLUSIONS: In contrast to mass-treatment strategies, significant reductions in trachoma prevalence at 6 months were achieved by screening 35% of community members (216) and treating 20% (124). The subsequent prevalence increases support the need for more comprehensive treatment programs, including health promotion and efforts to improve living conditions.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10772587&dopt=Abstract Zithromax azithromycin




Ophthalmology. 1998 Apr;105(4):658-61.
Pharmacokinetics of azithromycin [Zithromax] in trachoma patients: serum and tear levels.

Karcioglu ZA, El-Yazigi A, Jabak MH, Choudhury AH, Ahmed WS.

King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

OBJECTIVE: To determine the effectiveness of single-dose oral azithromycin [Zithromax] in the treatment of Chlamydia trachomatis through monitoring of tear and serum levels. DESIGN: Nonrandomized, clinical trial. PARTICIPANTS: Fourteen school-age children with active trachoma (one failed to complete the study). INTERVENTION: A single dose of azithromycin [Zithromax] (20 mg/kg) was administered orally to 14 patients, and tear and serum levels were determined with high-performance liquid chromatography at 12, 24, 48, 72, 96, 120, and 144 hours after administration. MAIN OUTCOME MEASURES: Azithromycin [Zithromax] levels in tears and serum. RESULTS: Peak levels of 1.53 microg/ml (standard deviation [SD] +/- 0.94) and 0.15 microg/ml (SD +/- 0.04) were obtained at 12 hours in both tears and serum, gradually decreasing over 144 hours. All patients were disease-free by 6 months. CONCLUSIONS: Levels of azithromycin [Zithromax] in patients with trachoma were found to be within minimum inhibitory concentration range for Chlamydia trachomatis (0.03-0.25 microg/ml) throughout the monitored period of 6 days.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9544640&dopt=Abstract Zithromax azithromycin

ren.nic.in

The effects of furazolidone, erythromycin and azithromycin [Zithromax] in inhibiting colonisation of Vibrio cholerae O1 and O139 in the rabbit intestine were tested. Both V. cholerae O1 and O139 highly colonised the gut in control rabbits. The colonisation of furazolidone-resistant strains in the rabbit intestine was prevented effectively by both erythromycin and azithromycin. In furazolidone-sensitive strains, the efficacies of erythromycin and azithromycin [Zithromax] were very much comparable to furazolidone. These results suggested that azithromycin [Zithromax] may be subjected to clinical trial in comparison to furazolidone and erythromycin for the treatment of cholera due to O1 and O139 infection in children.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9551241&dopt=Abstract Zithromax azithromycin




Inflammation. 1998 Apr;22(2):191-201.
Azithromycin [Zithromax] impact on neutrophil oxidative metabolism depends on exposure time.

Levert H, Gressier B, Moutard I, Brunet C, Dine T, Luyckx M, Cazin M, Cazin JC.

Laboratoire de Pharmacologie et Pharmacie Clinique, Faculte des Sciences Pharmaceutiques et Biologiques, Lille, France.

Several antimicrobial agents have already been investigated relating to their influence on neutrophil ROS generation. Azithromycin [Zithromax] provides, a dose-related anti-oxidant effect, after 15 min incubation, with the stimulating agent FMLP, as well with PMA or S. aureus. This finding was however obtained with concentrations not considered in therapeutics. Since short incubation times are not representative of the physiological situation, and since azithromycin [Zithromax] is characterized by prolonged high concentrations within phagocytes, the same experiments were performed over 2 and 4 h exposures. A time-dependent anti-oxidant effect was then reported. The maximum effect was obtained with PMA (IC50 were 856 and 30 micrograms/ml for 15 min and 4 h incubation times respectively). Time-dependent modifications of neutrophil oxidative metabolism seem to be correlated with intracellular concentrations. Depressed oxidative metabolism might be related neither to azithromycin [Zithromax] cellular toxicity, nor to superoxide scavenging properties. By increasing exposure periods, therapeutic concentrations could therefore lead to an anti-inflammatory effect, potentially of clinical interest since associated with bacteriostatic activity.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9561928&dopt=Abstract Zithromax azithromycin




J Antimicrob Chemother. 1998 Mar;41(3):387-9.
Anti-anaerobic activity of erythromycin, azithromycin [Zithromax] and clarithromycin: effect of pH adjustment of media to compensate for pH shift caused by incubation in CO2.

Ednie LM, Jacobs MR, Appelbaum PC.

Department of Pathology (Clinical Microbiology), Hershey Medical Center, PA 17033, USA.

The activity of erythromycin, azithromycin [Zithromax] and clarithromycin against 112 anaerobes was tested by the Oxyrase agar dilution MIC method at pH 7.2 without supplemental CO2 and by an agar dilution MIC method in CO2 with media adjusted to pH 8.0. MICs (mg/L) of erythromycin, azithromycin [Zithromax] and clarithomycin against Bacteroides fragilis ATCC 25285 and Bacteroides thetaiotaomicron ATCC 29741 were similar by the two methods. MICs for 94 clinical isolates tested by the two methods were within two dilutions of each other. Eighteen additional isolates required CO2, and did not grow in Oxyrase. With the exception of fusobacteria, with which azithromycin [Zithromax] yielded the lowest MICs, clarithromycin had the lowest MICs with both methods. These results show that the pH effect of incubation in CO2 can be avoided by using the Oxyrase method, or by incubating in CO2 with pH adjusted to 8.0. The latter method has the advantage of allowing testing of strains requiring CO2.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9578166&dopt=Abstract Zithromax azithromycin




Minerva Stomatol. 1998 Jan-Feb;47(1-2):57-62.
[The evaluation of the clinical efficacy and tolerance of azithromycin [Zithromax] in odontostomatological infections]

[Article in Italian]

Varvara G, D'Arcangelo C.

Cattedra di Odontoiatria Conservatrice, Universita degli Studi, Chieti.

BACKGROUND: Common oral bacteria are involved in the etiology of odontostomatological infections and there is a prevalence of Gram negative anaerobic microorganisms that are increasingly often found to be resistant to common beta-lactamases. In the light of this phenomenon, the use of beta-lactamases has been replaced by macrolides. The development of azithromycin, which is active against anaerobes and characterised by a wider spectrum of action against Gram negative bacteria, has opened new horizons in the therapeutic approach to odontostomatological infections. AIMS: The aim of the study was to evaluate the clinical efficacy and the tolerability of azithromycin [Zithromax] in odontostomatological infections. The study was performed using an open test method, without a comparative drug. METHODS: One hundred patients, including 51 males and 49 females aged between 18 and 64 years old, were included in the study. These patients showed clinical and radiographic symptoms of acute apical periodontitis, periodontal abscess, or third molar dysodontiasis. They were divided into three groups. The drug protocol used was 500 mg/day for three days. The efficacy of the antibiotic was assessed one week after the start of treatment by evaluating the evolution of the pathology on the basis of subjective symptoms (pain) and objective signs (reddening, swelling, basal temperature). A progressive system was used to quantify the clinical findings using an arbitrary score from 0 to 3. The tolerability of treatment was evaluated by recording any signs observed in the patients' data records. RESULTS: The initial mean score for painful symptoms passed from 2.88 to 0.34. The initial mean score for the reddening parameter also fell from 2.3 to 0.34. The same results were found for the reddening sign which presented a mean value of 2.1 at the start of treatment and 0.38 at the end. The 8 patients who presented fever also showed a remission. The overall incidence of side effects was 8%. The side effects affected the gastrointestinal tract. CONCLUSIONS: From an analysis of these results it can be affirmed that azithromycin [Zithromax] achieved good therapeutic results in odontostomatological infections in terms of both efficacy and tolerability.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9578649&dopt=Abstract Zithromax azithromycin