Mari Yamasue1, Kosaku Komiya1, Hiroki Yoshikawa1, Yoshihisa Kohno2, Yoshifumi Imamura3, Satoshi Otani4, Takehiko Shigenaga5, Hironobu Koga6, Kenji Kishi7, Tomoku Ichimiya8, Hironori Tanaka9, Kanako Hara10, Shingo Noguchi11, Kazuhiro Yatera11, Hiroshi Mukae3, Kazufumi Hiramatsu1, Jun-Ichi Kadota1. 1. Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, Yufu, Japan. 2. Department of Internal Medicine, Kouseikai Hospital, Nagasaki, Japan. 3. Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 4. Department of Respiratory Medicine, Oita Prefectural Hospital, Oita, Japan. 5. Department of Respiratory Medicine, Oita Red Cross Hospital, Oita, Japan. 6. Department of Internal Medicine, Aino Memorial Hospital, Unzen, Japan. 7. Department of Respiratory Medicine, Tsurumi Hospital, Beppu, Japan. 8. Department of Respiratory Medicine, Oita Medical Center, Yokota, Japan. 9. Department of Respiratory Medicine, Nijigaoka Hospital, Nagasaki, Japan. 10. Department of Internal Medicine, Kyushu Rosai Hospital, Kitakyushu, Japan. 11. Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Abstract
AIM: Pneumonia in older adults is increasingly recognized as a healthcare issue in countries with an aging population. Long-term macrolide therapy reduces exacerbations of chronic respiratory diseases, but its effects on the prevention of pneumonia have not been determined. METHODS: We carried out a randomized, controlled trial to test the effect of long-term clarithromycin therapy on the prevention of pneumonia among older adults. People aged ≥65 years who had recovered from pneumonia within the previous 3 months were recruited and randomly allocated to a long-term, low-dose clarithromycin (CAM) therapy group (n = 13) or a control group (n = 15). RESULTS: Both groups were followed up until recurrence of pneumonia. The median follow-up period was 251 days (95% CI 171-330) in the CAM group and 132 days (95% CI 67-196) in the control group (P = 0.627). The recurrence rate of pneumonia was two out of 13 (15%) in the CAM group and five out of 15 (33%) in the control group (P = 0.268). The median time to recurrence of pneumonia was 315 days (95% CI 249-382) in the CAM group and 260 days (95% CI 184-335) in the control group (P = 0.260). None of the differences between groups were statistically significant. CONCLUSIONS: No statistically significant suppressive effects of long-term, low-dose macrolide therapy on the development of pneumonia among older people were found in this small sample. A large-scale, randomized, controlled study is required. Geriatr Gerontol Int 2019; 19: 1006-1009.
RCT Entities:
AIM: Pneumonia in older adults is increasingly recognized as a healthcare issue in countries with an aging population. Long-term macrolide therapy reduces exacerbations of chronic respiratory diseases, but its effects on the prevention of pneumonia have not been determined. METHODS: We carried out a randomized, controlled trial to test the effect of long-term clarithromycin therapy on the prevention of pneumonia among older adults. People aged ≥65 years who had recovered from pneumonia within the previous 3 months were recruited and randomly allocated to a long-term, low-dose clarithromycin (CAM) therapy group (n = 13) or a control group (n = 15). RESULTS: Both groups were followed up until recurrence of pneumonia. The median follow-up period was 251 days (95% CI 171-330) in the CAM group and 132 days (95% CI 67-196) in the control group (P = 0.627). The recurrence rate of pneumonia was two out of 13 (15%) in the CAM group and five out of 15 (33%) in the control group (P = 0.268). The median time to recurrence of pneumonia was 315 days (95% CI 249-382) in the CAM group and 260 days (95% CI 184-335) in the control group (P = 0.260). None of the differences between groups were statistically significant. CONCLUSIONS: No statistically significant suppressive effects of long-term, low-dose macrolide therapy on the development of pneumonia among older people were found in this small sample. A large-scale, randomized, controlled study is required. Geriatr Gerontol Int 2019; 19: 1006-1009.