TABLE 2

Study Characteristics and Quality, in Chronological Order

StudyDesign/LengthPatientsIntervention/ComparatorRelevant OutcomesRelevant ResultsLevel of Evidence
Sterner et al (1967)RCT/1.5 y N = 180 (unknown ages) with CAPEES/cephaloridineFailure = daily fevers for 5 d or fever ≥10 d8/87 (EES) vs 17/93 (cephaloridine) failures. a Mean fever = 2.7 vs 3.8 d. In those with MP, 0/13 vs 3/9 failures. a Does not separate adults and children.2b
Ruhrmann et al (1982)RCT/1 y N = 120 (6 mo–14 yr) with CAPEES/amoxicillinFever durationMean fever = 2.6 ± 4.1 d (EES) vs 2.4 ± 1.9 d (amoxicillin).2b
Garo et al (1988)Retro, multisite cohort/5 y N = 182 (mean age = 29 y) with MPMP spectrum/no spectrumFever durationMean fever = 3 d (spectrum) vs 7 d (no spectrum). 84% presented with atypical pneumonia. Does not separate adults and children.4
Gomez Campdera et al (1996)RCT/2 y N = 155 (6 mo–16 y) with CAPAZM/co-amoxiclav (<5 y); EES (>5 y)Cured or improved at 3, 10, or 30 dAt 3, 10, and 30 d, respectively: 78/82 (AZM) vs 66/73 (comparator), a 80/82 vs 68/73, a and 80/82 vs 69/73. a No difference in duration of fever or cough. 15 total with MP.2b
Gendrel et al (1997)Pro, cohort/2 y N = 104 (1.5–13 y) with CAPMacrolide/β-lactamFever at 2–18 dIn children with MP: 11/11 (macrolide) vs 2/32 (β-lactam) became afebrile (P < .001). a 4
Harris et al (1998)Multisite, RCT/1.5 y N = 456 (6 mo–16 y) with CAPAZM/co-amoxiclav (<5 yr); EES (≥5 yr)1. Cured or improved at 15–19 dIn <5 y group: clinical success in 114/125(AZM) vs 59/63 (co-amoxiclav) at 15–19 d, a and 97/114 vs 41/48 at 4–6 wk. 1 35/310 vs 45/146 had adverse events (P < .001). a 1b
2. Cured or improved at 4–6 wk
3. Adverse events
Sáez-Llorens et al (1998)Multisite, RCT/2 y N = 335 (6 mo–15 y) with CAPAZM/co-amoxiclav (<5 yr); EES (≥5 yr)Cured or improved after 3 d of treatment96/97 (AZM) vs 114/116 (co-amoxiclav) cured or improved. In cases of MP, 9/9 and 5/5 cured or improved. a 2b
Wubbel et al (1999)RCT/2 y N = 174 (6 mo–16 y) with CAPAZM/co-amoxiclav (<5 yr); EES (≥5 yr)1. Cured 3 d after treatment68/69 (AZM) vs 75/78 (comparator) cured. 10/69 (AZM) vs 33/49 (co-amoxiclav) had adverse events (P < .001). a 2b
2. Adverse events
Ferwerda et al (2001)Multisite, RCT/3 y N = 118 (3 mo–12 y) with CAPAZM/co-amoxiclav1. Cured or improved at 10–13 dSuccess in 50/55 (AZM) vs 46/53 (co-amoxiclav) at 10–13 d and 46/51 vs 43/50 at 25–30 d. 33/59 vs 41/58 adverse events. a 1b
2. Cured or improved at 25–30 d
3. Adverse events
Principi et al (2001)Pro, multisite cohort/1 y N = 613 (2–14 y) with CAPMacrolide/no spectrumCured or improved at 4–6 wkIn subjects with MP or CP, success in 106/109 (macrolide) vs 67/82 (comparator) (P < .001). a 2b
Kogan et al (2003)RCT/3 y N = 110 (30 d–14 y) with CAPClassic CAP: AZM/amoxicillinClinical response:Mean fever = 1.7 d (AZM) vs 2.0 d (amoxicillin). By day 14 all 47 CXRs had improved by >75%.2b
 Fever duration
 CXR >75% improved
Esposito et al (2005), study ARCT/2 y N = 352 (1–14 y) with recurrent RTIAZM and symptomatic/symptomaticClinical success at 4–6 wk76/76 (AZM) vs 88/114 (comparator) with MP or CP had clinical success (P < .001).2b
Esposito et al (2005),study BRCT/2 y N = 352 (1–14 y) with recurrent RTIAZM and symptomatic/symptomatic≤2 RTIs at 6 mo53/71(AZM) vs 61/109 (comparator) with MP or CP ≤2 RTIs (P = .01). a 2b
Bradley et al (2007)Multisite, RCT/2 y N = 738 (6 mo–16 y) with CAPLevofloxacin/β-lactam (<5 yr); macrolide (≥5 yr)Improved or cured at 1–3 d and cured at 10–17 dSuccess was 409/441(levofloxacin) vs 138/147 (comparator) at 1–3 d and 439/503 vs 145/170 at 10–17 d.2b
Lu et al (2008)Retro, cohort/2 y N = 139 (8 mo–12 y) with MP CA-RTIMacrolide/no macrolideDuration of feverMean fever = 4.90 ± 1.89 d (macrolide) vs 5.63 ± 2.22 d (no macrolide) (P = .04).2b
Matsubara et al (2009)Retro, case–control/4 y N = 94 (0–14 y) with MP CAP treated with macrolideMacrolide sensitive MP/resistant MP1. Excellent or good clinical response43/47 (sensitive) vs 5/22 (resistant) had positive clinical response (P < .01). Mean fever = 1.5 vs 4.0 d (P < .01) and mean cough = 1.5 vs 4.0 d (P < .01).3b
2. Mean fever duration
3. Cough duration
Kawai et al (2012)Retro, case–control/5 y N = 29 (1–15 y) with MP CAP treated with macrolideMacrolide sensitive MP/resistant MP1. Afebrile 2 d after starting therapy8/8 (sensitive) vs 6/21 (resistant) became afebrile (P < .001). a Mean DNA load decreased significantly.3b
2. MP DNA load at 2 d
  • Differences not significant or not calculable unless otherwise stated. AZM, azithromycin; CP, Chlamydia pneumoniae; CXR, chest x-ray; EES, erythromycin ethylsuccinate; MP, Mycoplasma pneumoniae; pro, prospective; retro, retrospective; RTI, respiratory tract infection.

  • a Significance calculated by the review authors.