CLINICAL TRIAL FOR LEVOFLOXACIN VERSUS AMOXYCILLIN/CLAVULANIC ACID COMBINED WITH AZITHROMYCIN IN TREATMENT OF COMMUNITY ACQUIRED PNEUMONIA

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ABSTRACT Background Community acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Early initiation of antibiotics is highly recommended. In most CAP cases, multiple drug options are increasingly becoming available, but there is often a lack of evidence that allows for direct comparison of the efficacy of one drug versus another. The purpose of this study was to investigate the effectiveness of antibiotics so as to rationalize outpatient treatment of community acquired pneumonia among patients with previous antibiotic exposure. Aim The main objective was to compare treatment outcomes using oral levofloxacin alone and combined azithromycin and amoxicillin/Clavulanic acid in outpatient treatment of Community acquired pneumonia. Methods This study was a prospective longitudinal design. Patients diagnosed to have CAP were put into first and second treatment groups. Community acquired pneumonia was diagnosed according to America Thoracic Society criteria. Sample size of 76 was arrived at by Cochran’s formular. Variation in white blood cell counts at baseline and after treatment in the two treatment groups was analysed using ANOVA whereas differences in treatment outcome was analysed using the independent t-test. Results The findings of this study suggest that combination of azithromycin and amoxycillin/clavulanic acid was associated with statistically significant faster resolution of chest pains and cough (mean 1.7 and 3.14 days respectively) compared to levofloxacin group (mean 2.21 and 3.71 days respectively) in patients who had community acquired pneumonia (p=0.009). However, in the two treatment groups, there was no difference in the meantime to fever resolution, time to crackles subsidence, resolution of difficulty in breathing and change in white blood cell count. Conclusions Based on the quantitative analysis and methodology used by the current study, it can be concluded that although both treatment groups demonstrated similar effectiveness, combination of amoxicillin/clavulanic acid and azithromycin showed a modest superiority in relation to rate of symptom resolution and change in white blood cell count.

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