Atypical pneumonia in the Nordic countries: aetiology and clinical results of a trial comparing fleroxacin and doxycycline. Nordic Atypical Pneumonia Study Group

J Antimicrob Chemother. 1997 Apr;39(4):499-508. doi: 10.1093/jac/39.4.499.

Abstract

Community-aquired pneumonia caused by atypical bacteria or viruses was studied in a double-blind trial comparing fleroxacin 400 mg od and doxycycline 100 mg bd for 10 days. The aetiology was confirmed in 258 of 411 cases (66%), of which 133 were caused by Mycoplasma spp., Chlamydia spp. or Legionella spp.; 30 patients had viral infection, nine had pneumococcal or Haemophilus influenzae infection and 93 had mixed aetiology. In intention-to-treat analyses clinical response rates in fleroxacin-treated patients were 86% (157/182) and 75% (137/182) 2-8 days and 3-5 weeks after therapy, respectively. Corresponding results with doxycycline were 93% (177/191) and 85% (162/190), respectively. Differences between treatments seemed to be due to the lower activity of fleroxacin compared with doxycycline against mycoplasma and pneumococci. Drug-related adverse events were reported in 39% of 204 fleroxacin patients and in 34% of 207 doxycycline patients. The null hypothesis that fleroxacin was <15% inferior to doxycycline was accepted at early follow-up but rejected at later review.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Chlamydia Infections / drug therapy
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / etiology
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology
  • Denmark
  • Double-Blind Method
  • Doxycycline / adverse effects
  • Doxycycline / therapeutic use*
  • Finland
  • Fleroxacin / adverse effects
  • Fleroxacin / therapeutic use*
  • Humans
  • Iceland
  • Legionellosis / drug therapy
  • Legionellosis / epidemiology
  • Legionellosis / etiology
  • Longitudinal Studies
  • Mycoplasma pneumoniae / drug effects
  • Norway
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / epidemiology
  • Pneumonia, Bacterial / etiology*
  • Sleep Initiation and Maintenance Disorders / chemically induced
  • Sweden

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Doxycycline
  • Fleroxacin