Legionella species have been widely recognized as among the important causative organisms of community-acquired
pneumonia in Japan. A delay in the start of adequate treatment has a negative influence on the outcome of the disease.
Telithromycin, the first oral ketolide antibacterial, was developed for the treatment of community-acquired
pneumonia, including Legionella
pneumonia. However, few reports have indicated the efficacy of
telithromycin in community-acquired
pneumonia caused by Legionella species. We report three cases of Legionella
pneumonia, that were improved by early
telithromycin therapy. The first patient (67-year-old man) had
bronchiectasis as an underlying disease, and the second patient (73-year-old man) had
diabetes mellitus and
chronic renal failure. The third patient (62-year-old man) developed
pneumonia after a spa tour. The diagnosis of Legionella
pneumonia was made on the basis of the presence of a single
IgG titer of 1/256 in case 1 and positive antigenuria in cases 2 and 3. The patients were classified into a mild group (case 1) and a moderate group (cases 2 and 3) based on the severity of the community-acquired
pneumonia according to the 2005 Japanese Respiratory Society Guidelines. The results support the efficacy of
telithromycin in mild to moderate Legionella
pneumonia.