Two regimens of azithromycin prophylaxis against community-acquired respiratory and skin/soft-tissue infections among military trainees.

Abstract

Epidemics of community-acquired pneumonia (CAP) are a frequent cause of morbidity among Russian military trainees. We evaluated azithromycin prophylaxis against CAP. In 2001-2002, incoming military trainees were randomized to 1 of 3 trial arms by training group: azithromycin, 500 mg per week for 8 weeks (R1); azithromycin, 1500 mg once at enrollment (R2); or no therapy (R3). During the 22 weeks of training, CAP was diagnosed in 20.2% of 678 subjects in the R3 group, 8.6% of 508 subjects in the R1 group, and 10.3% of 507 subjects in the R2 group. Throat carriage cultures revealed that the proportion of Streptococcus pneumoniae isolates with resistance to macrolides correspondingly increased during the study, from 0% (all) to 40% (R1) and 22.6% (R2) by week 20. Azithromycin prophylaxis is effective against CAP in a healthy population of young men at transient high risk of disease; however, azithromycin use must be tempered with the possible concomitant risk of selection for resistant endemic pathogens.

• Authors: Igor A Guchev, Gregory C Gray, Oleg I Klochkov
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 38 Issue 8 Pg. 1095-101 (Apr 15 2004) ISSN: 1537-6591 [Electronic] United States
• PMID: 15095213 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Azithromycin

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Antibiotic Prophylaxis
• Azithromycin (therapeutic use)
• Community-Acquired Infections (prevention & control)
• Humans
• Male
• Military Personnel
• Prospective Studies
• Respiratory Tract Infections (prevention & control)
• Risk Factors
• Soft Tissue Infections (prevention & control)