Levofloxacin versus ceftriaxone and azithromycin for treating community-acquired pneumonia: a randomized clinical trial study

Davood Yadegarynia; Shabnam Tehrani; Fatemeh Maghsoudi Nejad; Fatemeh Shojaeian; Amirreza Keyvanfar

doi:10.18502/ijm.v14i4.10231

Davood Yadegarynia Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Shabnam Tehrani Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Fatemeh Maghsoudi Nejad Department of Infectious Diseases, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Fatemeh Shojaeian Department of Surgical Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, US
Amirreza Keyvanfar Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijm.v14i4.10231

Keywords: Pneumonia; Community-acquired infections; Anti-bacterial agents; Levofloxacin; Ceftriaxone; Macrolides; Clinical trial

Abstract

Background and Objectives: We compared two common antibiotic regimens for the treatment of mild to moderate CAP: levofloxacin versus β-lactam and macrolide combination; in terms of their efficacy and side effects.

Materials and Methods: Patients with mild to moderate CAP were randomized into two groups. Group I received a combi- nation of 1 gram ceftriaxone daily and 500 mg azithromycin daily for 5-7 days. Group II received levofloxacin 750 mg daily for five days. The signs and symptoms, hospitalization length, and the side effects were investigated.

Results: There were 77 and 74 patients in groups I and II. The vital signs of group II were significantly better on the 3rd day of admission, except for the temperature (P=0.09). The O saturation of group II was markedly improved on the 5th day of admission (P=0.0061). In terms of clinical symptoms and hospitalization length, group II was considerably better. However, the rate of side effects in both groups was similar (P=0.885).

Conclusion: Hospitalized patients with mild to moderate CAP might take more advantage of fluoroquinolone administra- tion. It could improve the patients' signs and symptoms and reduce hospitalization length, compared with the combination of macrolide and cephalosporin, with the same rate of side effects.