TY - JOUR T1 - Should clarithromycin not be prescribed against haemophilus influenza? JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P4380 AU - Rajesh Yadavilli AU - Rosalind Benson AU - Elijah Matovu AU - Vinay Shanker Sreeguru Lakshman AU - Sanjeev Agarwal Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P4380.abstract N2 - Introduction:Macrolides are less effective against extracellular pathogens like Haemophilus influenza(HI).Clarithromycin is commonly used Macrolide for respiratory tract infections and can be administered in HI related infections.Hypothesis:Translation of In-vitro to In-vivo antibiotic resistance leads to treatment failure and result in recurrent hospital admission.Methods:Patients admitted to a teaching hospital with HI related respiratory infections were identified and followed for recurrent admission between Jan 2010 and Dec 2011. Antibiotic administered, resistance in-vitro and readmission within 30 days were studied.Results:No of patients: 150; Total HI related admissions-277; Total sputum samples obtained -217 and all grew HI.In-vitro antibiotic resistance to Clarithromycin is 217(100%), Amoxicillin is 65(30%), and Doxycycline is only 9(4%) cases.In-vitro to In-vivo translation of resistance measured as hospital readmission within 30 days from discharge was 66% with Clarithromycin, 10% with Amoxicillin, and 3% with Doxycycline.70% of patients treated with Doxycycline had no hospital readmission.Conclusions:HI was noted to be resistant to Clarithromycin in-vitro in 100% cases in our study. This was translated in-vivo and associated with high readmission rates within 30 days, representing treatment failure. We therefore recommend avoiding Clarithromycin if the patient is known to have previous HI infection.Doxycycline had the least readmission rates in our study and should be the antibiotic of choice against HI especially in patients with penicillin allergy.We hereby conclude selection of antibiotic is extremely important to prevent treatment failure and there by readmissions. ER -