Pilot Study of LongSterm Azithromycin Prophylaxis of Acute Bacterial Infections of Respiratory Tract in Military Persons

Clinical Microbiology and Antimicrobial Chemotherapy. 2000; 2(1):31-36

Journal article


Introduction Azithromycinis anazalide with high activity against most frequent pathogens causing respiratory community-acquired infections – Streptococ cus spp., Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, – an d long tissue concentrations. These features make it very attractive for use inprophylaxis of bacterial respiratory tract infections. The objective of this study was to determine azithromycin ability to prevent respiratory tract infection during winter period among military recruits.

Materials and Methods.

Two groups of military recruits (100 males in each group) were entered the same training center near Moscow in January 1999. There were no differences in weight, health status, training programs, living conditions, and medical control. Serological identificationbefore inclusioninthe trial and afterwards for M. pneumoniae was performed by ELISA (IgG and IgM), C. pneumoniae was identified by MIF (IgA, IgM and IgG). Recruts in the first group were randomized to receive azithromycin0,5g once a week for 8 weeks (January – February) under doctor’s control. The second group recruits made similar visits to doctor but did not receive azithromycin. The statistic evaluationwas performed by χ2>test.


Among azithromycin group upper respiratory tract infections occurred in 6 versus 12 recruits in control group (statistically not significant, p>0,05). Lower respiratory tract infections (bronchitis and pneumonia) were developed in 4 recruits in azithromycingroup and in13 – incontrol group (p<0,05). Seropositive reactionfor *C. pneumoniae* among azithromycingroup was found in37 recruits versus 43 incontrol group, for *Mycoplasma pneumoniae* in 15 recruits from azithromycingroup versus 12 among control group (difference not valid, p>0,05). Seroconversion which indicate active process in azithromycingroup was lower thanincontrol group (2 recruits for M. pneumoniae, 3 recruits for C. pneumoniae versus 8 recruits for M. pneumoni ae and 7 recruits for C. pneumoniae, respectively) but the differences were not statistically significant (p>0,05). Both groups have similar level of unfavorable events.


Weekly azithromycinprophylaxis among healthy recruits during winter period reduce frequency of lower respiratory tract infections. Reduction of upper respiratory tract infections in this trial was not statistically significant which could be reflected by the high frequency of occurrence of viruses in this pathology.

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