Weekly oral azithromycin as prophylaxis for agents causing acute respiratory disease

Gregory C. Gray, Dennis C. McPhate, Maija Leinonen, Gail H. Cassell, Eduardo P. Deperalta, Shannon D. Putnam, Jennifer A. Karcher, Mark H. Sawyer, Aino Laurila, James D. Connor

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Since the 1950s the U.S. military has used intramuscular injections of benzathine penicillin G (BPG) to control outbreaks of respiratory disease. In an effort to find an alternative prophylaxis, a randomized field trial was conducted among 1,016 male U.S. Marine trainee volunteers at high risk for respiratory disease. Participants were evaluated for evidence of acute respiratory infection by serological tests on pretraining and posttraining sera (63 days apart). Oral azithromycin prophylaxis (500 mg/w) outperformed BPG, preventing infection from Streptococcus 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 = 58%; 95% CI, 15%-79%) in comparison with results in a no-treatment group. Azithromycin group subjects reported few side effects and less respiratory symptoms than the BPG and no-treatment groups. According to serological tests, oral azithromycin is an effective alternative prophylaxis to BPG for military populations.

Original languageEnglish (US)
Pages (from-to)103-110
Number of pages8
JournalClinical Infectious Diseases
Issue number1
StatePublished - 1998
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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