Jumana Al-SalloumGulf Medical University, United Arab Emirates
Title: Comparative Efficacy of Azithromycin Versus Clarithromycin in Combination with Beta-lactams for the Treatment of CAP
Objective: The objective of this systematically review is to compare efficacy of azithromycin and clarithromycin in combination with b-lactams in the treatment of community acquired pneumonia among hospitalized adults.
Methods: Primary comprehensive search was performed in 5 main databases (pubmed, google scholar, trip, medline, and clinical key) to identify randomized clinical trials with patients exposed to azithromycin or clarithromycin in combination with a beta-lactam using specific mesh terms. All the articles were critically reviewed for inclusion following prisma and using sign tool to evaluate the quality of the studies included.
Results: A total of 7 clinical trials were included in the qualitative evidence synthesis. An average of 87.55% for azithromycin-b-lactam at day 10-14 and 75.42% for clarithromycin-b-lactam at day 5-7 of therapy, was identified. Streptococcus pneumonia was commonly found in both macrolides’ groups with 130 isolates in clarithromycin-based combination and 80 isolates in azithromycin-based group. An average mean day in length of hospital stay of 8.45 days was found in patients receiving b-lactams with azithromycin combination and 7.25 days with clarithromycin combination.
Conclusion: The review reported macrolide inter-class differences, with higher clinical success rate reported with azithromycin-based combination. However, shorter length of hospital stay is achieved with clarithromycin-beta-lactam regimen. Hence, the choice of the macrolide to be combined with a b-lactam should be guided with susceptibility data of the treating facility.
Jumana has completed her PharmD degree from the Gulf Medical University, UAE after that she obtained her master in clinical pharmacy with infectious disease from the same GMU. She is working as lecturer in GMU at the college of pharmacy and as clinical pharmacist at the affiliate university hospital. Her area of expertise is emergency, pediatric and infectious disease. Jumana earned BCPS certification and became a certified pharmacotherapy specialist in late 2021. She has a couple of publications as well in the field of clinical pharmacy.