Value of short-course antimicrobial therapy in community-acquired pneumonia

Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. Non-compliance with therapy may be associated with deterioration in the patient' s condition, treatment failure, and increased use and cost of healthcare resources such as the requirement for additional drugs and hospital admission. Adherence to the prescribed regimen is affected by a number of variables including dosing interval, treatment duration, adverse effects, and palatability in pediatric patients. Accumulating evidence suggests that short-course antimicrobial therapy may be at least as effective as, and in some cases may be more effective than, traditional longer therapies (7-14 days) even in hospital-acquired pneumonia. Given the unique pharmacokinetic properties of azithromycin, attempts have been made to condense the traditional total dose over a 3-5-day period into single-dose therapy with the aim of improving treatment compliance. The results of two phase III CAP trials indicate that a single 2.O g dose of azithromycin microspheres is a suitable alternative to 7 days of either clarithromycin XL or levofloxacin.