Journal Article

Weekly Oral Azithromycin as Prophylaxis for Agents Causing Acute Respiratory Disease

Gregory C. Gray, Dennis C. McPhate, Maija Leinonen, Gail H. Cassell, Eduardo P. Deperalta, Shannon D. Putnam, Jennifer A. Karcher, Mark H. Sawyer, Aino Laurila and James D. Connor

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 1, pages 103-110
Published in print January 1998 | ISSN: 1058-4838
Published online January 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516275
Weekly Oral Azithromycin as Prophylaxis for Agents Causing Acute Respiratory Disease

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Since the 1950s the U.S. military has used intramuscular injections of benzathine penicillin G (BPG) to control outbreaks of respiratory disease. In an effort to find an alternative prophylaxis, a randomized field trial was conducted among 1,016 male U.S. Marine trainee volunteers at high risk for respiratory disease. Participants were evaluated for evidence of acute respiratory infection by serological tests on pretraining and posttraining sera (63 days apart). Oral azithromycin prophylaxis (500 mg/w) outperformed BPG, preventing infection from Streptococcus pyogenes (Efficacy [E] = 84%; 95% confidence interval [CI], 63%–93%), Streptococcus pneumoniae (E = 80%; 95% CI, 50%– 92%), Mycoplasma pneumoniae (E = 64%; 95% CI, 25%–83%), and Chlamydia pneumoniae (E = 58%; 95% CI, 15%–79%) in comparison with results in a no-treatment group. Azithromycin group subjects reported few side effects and less respiratory symptoms than the BPG and no-treatment groups. According to serological tests, oral azithromycin is an effective alternative prophylaxis to BPG for military populations.

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

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