Treatment of legionellosis including a single intravenous dose of 1.5 g azithromycin: 18-year experience at a tertiary care hospital

Int J Antimicrob Agents. 2022 Jan;59(1):106481. doi: 10.1016/j.ijantimicag.2021.106481. Epub 2021 Nov 18.

Abstract

Objectives: Due to recent safety concerns regarding fluoroquinolones and the potential medical and economic benefits, we investigated the efficacy of a single intravenous dose of 1.5 g azithromycin for the treatment of pulmonary legionellosis.

Methods: Using a nationwide legionellosis registry for pre-selection, 74 patients admitted from 2000-2018 to a tertiary care hospital owing to pneumonia caused by Legionella pneumophila were retrospectively included in this study.

Results: Conventional treatment regimens consisting of fluoroquinolones (n = 20), macrolides (n = 30) or combinations of both (n = 24) and a single intravenous dose of azithromycin (n = 12) have been demonstrated to be equally effective. Single-dose azithromycin treatment was well tolerated and resulted in a shorter hospital stay (P = 0.0464) and shorter antibiotic treatment duration (P = 0.0004) allowing earlier discharge.

Conclusion: A single intravenous dose of azithromycin might be a valuable treatment alternative for patients with legionellosis.

Keywords: Antimicrobial therapy; Azithromycin; Fluoroquinolones; Legionella pneumophila; Legionnaires’ disease; Pneumonia.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Austria
  • Azithromycin / therapeutic use*
  • Female
  • Fluoroquinolones / therapeutic use*
  • Humans
  • Legionella pneumophila / drug effects
  • Legionellosis / drug therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Azithromycin