Journal Article

Two Regimens of Azithromycin Prophylaxis against Community-Acquired Respiratory and Skin/Soft-Tissue Infections among Military Trainees

Igor A. Guchev, Gregory C. Gray and Oleg I. Klochkov

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 8, pages 1095-1101
Published in print April 2004 | ISSN: 1058-4838
Published online April 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/382879
Two Regimens of Azithromycin Prophylaxis against Community-Acquired Respiratory and Skin/Soft-Tissue Infections among Military Trainees

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Epidemics of community-acquired pneumonia (CAP) are a frequent cause of morbidity among Russian military trainees. We evaluated azithromycin prophylaxis against CAP. In 2001–2002, incoming military trainees were randomized to 1 of 3 trial arms by training group: azithromycin, 500 mg per week for 8 weeks (R1); azithromycin, 1500 mg once at enrollment (R2); or no therapy (R3). During the 22 weeks of training, CAP was diagnosed in 20.2% of 678 subjects in the R3 group, 8.6% of 508 subjects in the R1 group, and 10.3% of 507 subjects in the R2 group. Throat carriage cultures revealed that the proportion of Streptococcus pneumoniae isolates with resistance to macrolides correspondingly increased during the study, from 0% (all) to 40% (R1) and 22.6% (R2) by week 20. Azithromycin prophylaxis is effective against CAP in a healthy population of young men at transient high risk of disease; however, azithromycin use must be tempered with the possible concomitant risk of selection for resistant endemic pathogens.

Journal Article.  3591 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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