Effect of maclorides on duration and resolution of symptoms and complication of pneumonia in children with influenza.

Unlabelled: We randomly administered cephalosporins or macrolides to 365 pediatric patients with influenza-like symptoms and compared the clinical course and complication rate of pneumonia. One hundred and fifty-four patients received cephalosporins (Group 1) and 211 received macrolides (Group 2). There were no significant differences in age, male/female ratio and body weight between the two groups. Macrolides alleviated fever significantly faster than cephalospoins (3.8plus minus 1.4 days vs 4.3plus minus 1.4 days), though maximum body temperature showed no significant difference between the two groups. Thirty-nine patients underwent laboratory examinations and twenty-nine had high influenza A (H3N2) virus haemagglutinate inhibition (HI) titer, six had high influenza B (B1) virus HI titer and four did not show any elevation of influenza virus HI titer. Thirteen patients in Group 1 and two patients in Group 2 suffered from pneumonia and the complication rate was significantly lower in Group 1 than in Group 2 (8.4% vs 0.9%). All of them recovered within two weeks and did not have any other complications.

Conclusion: Macrolides are more effective in reducing the time required to alleviate fever and complication rate of pneumonia than cepharosporines in children with influenza and influenza-like illness. These results indicate that macrolides may have therapeutic value for influenza virus infection.