Community acquired
pneumonia (CAP) is the sixth leading cause of death. Atypical
pneumonia caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila accounts for up to 40% of all cases of CAP. Atypical
pneumonia due to Mycoplasma and Chlamydophila usually cause milder forms of
pneumonia and are characterized by a more drawn out course of symptoms unlike other forms of
pneumonia which can come on more quickly with more severe early symptoms.
Mycoplasma pneumonia often affects younger people and may be associated with symptoms outside of the lungs (such as
anemia and rashes), and neurological syndromes (such as
meningitis,
myelitis, and
encephalitis). Severe forms of
Mycoplasma pneumonia have been described in all age groups.
Chlamydophila pneumonia occurs year round and accounts for 5-15% of all
pneumonias. It is usually mild with a low mortality rate. In contrast, atypical
pneumonia due to Legionella accounts for 2-6% of
pneumonias and has a higher mortality rate. Elderly individuals, smokers, and people with
chronic illnesses and weakened immune systems are at higher risk for this type of
pneumonia. Contact with contaminated
aerosol systems (like infected air conditioning systems) has also been associated with
pneumonia due to Legionella. All of known
macrolides, including
azythromycin and clarythromycin, have excellent activity against the atypical respiratory pathogens. The are primarily bacteriostatic, by binding to the 50S subunit of the ribosome, they inhibit
bacterial protein. The potential indications for treatment lower
respiratory tract infections with
macrolides were presented in this study.