Comparison of hospitalization rates in patients with community-acquired pneumonia treated with telithromycin for 5 or 7 days or clarithromycin for 10 days

Abstract

SUMMARYAims: To compare the impact on hospitalization rates and the clinical efficacy of oral telithromycin and clarithromycin treatment in patients with community-acquired pneumonia (CAP).Methods: A total of 581 patients with CAP were enrolled in this randomized, double-blind, parallel-group, multinational study, of whom 575 were evaluated for healthcare resource utilization from a payer perspective (intent to treat [ITT] population). Patients received telithromycin 800 mg once daily for 5 (n = 193) or 7 (n = 195) days, or clarithromycin 500 mg once daily for 10days (n = 187). The primary efficacy endpoint was clinical outcome at test of cure (Days 17–24) in the per-protocol population. Frequency of CAP-related hospitalizations, physician visits/tests/procedures, and additional respiratory tract infection-related antibacterial use were compared by treatment group (ITT) up to late post-therapy (Days 31-36). Study investigators blinded to treatment assessed whether hospital admissions were CAP-related or not. CAP-relatedhospitalization costs (US$) for telithromycin and clarithromycin were compared.Results: Clinical cure rates were similar in patients who received clarithromycin for 10days and telithromycin for 5 or 7 days: 91.8% (134/146), 89.3% (142/159), and 88.8% (143/161), respectively, and both 5- and 7-day telithromycin were statistically equivalent to clarithromycin (difference: −2.5 and −3.0%, respectively; 95% CI: −9.7, 4.7 and −10.2, 4.3, respectively). There were 7 CAP-related hospital admissions among clarithromycin patients vs 3 (p = 0.283) and 1 (p = 0.021) admissions among 5- and 7-day telithromycin patients, respectively. The number of hospital days/100 patients was 40.1 for clarithromycin vs 17.1 and 7.2 for 5- and 7-day telithromycin, respectively. Projected hospitalization costs/100 patients were $86205 for clarithromycin vs $37930 (difference: −26446; 95% CI: −66654; 13762) and $16 091 (difference: −37847; 95% CI: −77953; 2259) for 5- and 7-day telithromycin, respectively.Conclusions: Data from this study demonstrate that telithromycin 800 mg once daily for 5 or 7 days is an effective treatment for CAP, and that telithromycin treatment of CAP may be associated with fewer hospital days and potentially lower hospitalization costs than clarithromycin treatment.