Features of community-acquired pneumonia treatment with 3rd generation cephalosporins in combination with azithromycin and as monotherapy

Abstract

Aim. To refine the indications for oral administration of a combination of 3rd generation cephalosporins together with azithromycin and also as monotherapy in patients with moderate and severe community-acquired pneumonia. Methods. A questionnaire was developed to evaluate the clinical and laboratory data on the 1st, 3rd, 5th, 7th and 10-14th days of treatment. The patients were included in the study if clinical signs of pneumonia were present, the disease occurred outside a hospital, and if there was radiological verification of lung tissue infiltration. The study included 77 patients (32 women and 45 men) aged 16 to 84 years. In 56 patients (73%) pneumonia had signs of a moderate course, in 21 (27%) - a severe course. Results. As a result of treatment the number of patients without shortness of breath significantly increased. The difference in comparison with the time of hospitalization was statistically significant starting from day 7 of treatment in patients treated with ceftriaxone and azithromycin (31 and 69%, p 0.05). Intergroup differences also became significant on the same time since treatment initiation (43% of patients on monotherapy, p 0.05). The increase in the proportion of patients without shortness of breath, receiving only ceftriaxone in comparison with the beginning of treatment became significant only by the 10th day (18 and 54%, p 0.05). Conclusion. A combination antibiotic therapy is indicated for patients with a severe course of disease and clinically significant dyspnea, as well as for women with a moderate community-acquired pneumonia with a productive cough. No significant differences in the safety and tolerability of the studied variants of treatment options have been revealed.