[Clarithromycin switch therapy in adult patients suffering from community-acquired lower respiratory tract infections (LRTIs) requiring hospitalisation]. / La terapia sequenziale (switch-therapy) con claritromicina nelle infezioni delle basse vie respiratorie acquisite in comunita' che richiedono ospedalizzazione.

ABSTRACT

39 subjects aged 53-85 years suffering from COPD, admitted to our Unit, were enrolled in our study four patients were diagnosed as having CAP; 35 patients meet the criteria of COPD exacerbation. The enrolled patients had been receiving clarithromycin (CLA) 500 mg i.v. every 12 hours; switching to oral therapy was decided on the basis of Ramirez's criteria. The mean total duration (SD) of treatment with CLA was 9.56 (1.87) days. During the study, 2 patients dropped out because of the detection of malignant tumoral cells in the sputum in one case and admission to the Intensive Care Unit because of pulmonary thromboembolism in the other. The clinical assessment made 24-72 hours after the end of the treatment confirmed the clinical efficacy of CLA (cure + improvement) in 35 out of 37 evaluable patients (94.59%). At the first follow-up visit, clinical efficacy was confirmed in 34 patients (91.89%). At the long-term follow-up visit, performed 30-45 days after the end of the study, none of the 34 "cured" patients had relapsed. Local and systemic tolerability was excellent in all patients, and no side effect attributable to the drug was reported. Our experience with switched clarithromycin therapy in patients with LRTIs confirms the validity of this approach.