WEEKLY ORAL AZITHROMYCIN AS PROPHYLAXIS FOR AGENTS CAUSING ACUTE RESPIRATORY-DISEASE

Since the 1950s the U,S, military has used intramuscular injections of benzathine penicillin G (BPG) to control outbreaks of respiratory dis ease, In an effort to find an alternative prophylaxis, a randomized fi eld trial was conducted among 1,016 male U,S, Marine trainee volunteer s at high risk for respiratory disease, Participants were evaluated fo r evidence of acute respiratory infection by serological tests on pret raining and posttraining sera (63 days apart), Oral azithromycin proph ylaxis (500 mg/w) outperformed BPG, preventing infection from Streptoc occus pyogenes (Efficacy [E] = 84%; 95% confidence interval [CI], 63%- 93%), Streptococcus pneumoniae (E = 80%; 95% CI, 50%-92%), Mycoplasma pneumoniae (E = 64%; 95% CI, 25%-83%), and Chlamydia pneumoniae (E = 5 8%; 95% CI, 15%-79%) in comparison with results in a no-treatment grou p, Azithromycin group subjects reported few side effects and less resp iratory symptoms than the BPG and no-treatment groups, According to se rological tests, oral azithromycin is an effective alternative prophyl axis to BPG for military populations.