TABLE 4.

Clinical trials for treatment of community-acquired pneumonia in which tests to identify infections with M. pneumoniae were included

AuthorsReferencePatientsDrug(s)M. pneumoniae infections
No. of casesDetection method(s)Outcome and/or comment
Cassell et al. 63 AdultsClarithromycin (14 days) vs erythromycin (14 days)15Culture, serologyClinical cure was achieved in 4 of 4 (100%) and 3 of 3 (100%) subjects receiving clarithromycin or erythromycin, respectively
Block et al. 47 ChildrenClarithromycin (10 days) vs erythromycin (10 days)69Culture, PCR, serologyMycoplasma eradication was achieved in 9 of 9 (100%) culture-positive evaluable subjects who received clarithromycin vs 4 of 4 (100%) who received erythromycin; eradication rates based on PCR alone were 19 of 22 (86%) vs 24 of 26 (92%) for clarithromycin and erythromycin, respectively (however, significance of a positive PCR assay after treatment is unknown)
Wubbel et al. 446 ChildrenAzithromycin (5 days) vs erythromycin (10 days) or amoxicillin-clavulanate (10 days)12Culture, PCR, serologyAll subjects with mycoplasma infection were classified as having clinical cure after treatment with any agent; however, 1 subject in the azithromycin group had a positive follow-up culture and 1 had a positive PCR
Harris et al. 180 ChildrenAzithromycin (5 days) vs erythromycin (10 days) or amoxicillin-clavulanate (10 days)124Culture, PCR, serologyMycoplasma eradication was achieved in 14 of 14 (100%) culture-positive evaluable subjects who received azithromycin vs 4 of 6 (67%) with erythromycin and 0 of 1 with amoxicillin-clavulanate
Schonwald et al. 368 AdultsAzithromycin (3 vs 5 days)43SerologyA 1.5-g total dose of azithromycin was equally effective when administered as a 3- or a 5-day regimen and resulted in clinical cure for all mycoplasmal infections that were encountered
Schonwald et al. 367 AdultsAzithromycin (single dose vs 3 days)24SerologyA single 1.5-g dose of azithromycin was equally effective as a 3-day regimen for treatment of mycoplasmal infection
Schonwald et al. 366 AdultsAzithromycin (5 days) vs erythromycin (10 days)55SerologyTherapeutic success was achieved for all subjects with mycoplasma infection who received either drug
Kaku et al. 216 AdultsRoxithromycin13Culture, serologyClinical efficacy was documented in 12 of 13 (93%) cases; a bacteriological effect was achieved in 4 of 6 (67%) cases
Patel et al. 322 AdultsMoxifloxacin (10 days)29Culture, serologyA bacteriological response occurred in 27 of 29 (93%) subjects with mycoplasmal infection
Finch et al. 140 AdultsMoxifloxacin (7-14 days) vs amoxicillin-clavulanate with or without clarithromycin (7-14 days)30SerologyClinical success was documented 21-28 days after the end of treatment in 12 of 13 (93%) subjects who received moxifloxacin and in 16 of 17 (94%) who received the comparator agents
Plouffe et al. 326 AdultsOfloxacin vs standard treatments with a variety of agents for different durations38SerologyClinical improvement or cure occurred in 13 of 14 (88%) subjects who were serologically positive for mycoplasma and in 20 of 22 (91%) who received various other treatments
File et al. 138 AdultsGemifloxacin (7 days) vs trovafloxacin (7 days)88Culture, serologyClinical success for mycoplasmal infections was documented in 41 of 44 (94%) subjects who received gemifloxacin and in 38 of 40 (95%) who received trovafloxacin
File et al. 139 AdultsLevofloxacin (7-14 days) vs ceftriaxone (7-14 days) or cefuroxime (7-14 days)41SerologyClinical improvement or cure was documented in 19 of 19 (100%) subjects treated with levofloxacin and in 22 of 22 (100%) who received either ceftriaxone or cefuroxime; the apparent response to cephalosporins may represent self-limited disease or the presence of an undiagnosed copathogen
Carbon et al. 57 AdultsTelithromycin (7-10 days)8SerologyAll eight patients with mycoplasmal infection had clinical cure
Pullman et al. 336 AdultsTelithromycin, trovafloxacin93Serology, culture, PCRClinical cure was documented in 4 of 4 subjects with mycoplasmal infection who received telithromycin and in 5 of 5 who received trovafloxacin