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 (3.8± 1.4 days vs 4.3± 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.
2002 by the Medical Association of Nippon Medical School