***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: STUDY OBJECTIVES To compare the efficacies of 10-day regimens of grepafloxacin ( GFX ) ( Raxar or Vaxar ; Glaxo Wellcome ; Greenford , UK ) , 600 qd , and clarithromycin ( CLA ) ( Klacid , Biaxin , or Klaracid ; Abbott Laboratories ; Chicago , IL ) , 500 mg bid , in patients with community-acquired pneumonia ( CAP ) , on the basis of clinical response , including radiographic evidence , and bacteriologic efficacy . DESIGN Phase IIIb , double-blind , double-dummy , r and omized , prospect i ve , parallel-group , comparative study conducted at 58 centers in 11 countries . PATIENTS AND SETTING Adult patients with signs and symptoms of CAP that was confirmed by radiographic evidence and who did not require parenteral therapy were included in the study . ASSESSMENT S Patients were assessed before treatment , during treatment , after treatment , and at follow-up ( 28 to 35 days after treatment completion ) . Clinical response was evaluated . Blood and sputum sample s were cultured for bacterial pathogens , and serology testing was performed to detect atypical pneumonia . RESULTS A total of 504 patients were enrolled into the trial : 251 were r and omly assigned to receive GFX and 253 to receive CLA . In patients able to be clinical ly evaluated , clinical success rates at follow-up were 147 of 163 patients ( 90 % ) in the GFX group and 148 of 167 patients ( 89 % ) in the CLA group ( 95 % confidence interval , -6 % to 9 % ) . Pretreatment pathogens were confirmed in 131 of 504 patients ( 26 % ) , either by culture or serology testing , the primary pathogens being Streptococcus pneumoniae ( 22 % ) , Haemophilus influenzae ( 17 % ) , Mycoplasma pneumoniae ( 25 % ) , and Chlamydia pneumoniae ( 11 % ) . For patients able to be evaluated who had typical pathogens , bacteriologic success was achieved in 92 % of the patients in each treatment group . For patients able to be evaluated who had atypical pathogens , 18 of 18 patients ( 100 % ) in the GFX and 23 of 26 patients ( 88 % ) in the CLA group had a successful clinical outcome . There were similar rates of adverse events in each group , result ing in < /= 7 % withdrawal from treatment ; gastrointestinal events were the most common . CONCLUSIONS GFX , 600 mg qd , was equivalent to CLA , 500 mg bid , in treating adult patients with CAP . Both treatments were well tolerated ABSTRACT Although azithromycin is extensively used in the treatment of respiratory tract infections as well as skin and skin-related infections , pharmacokinetics of azithromycin in extracellular space fluid of soft tissues , i.e. , one of its therapeutic target sites , are not yet fully eluci date d. In this study , azithromycin  concentration-time profiles in extracellular space of muscle and subcutaneous adipose tissue , but also in plasma and white blood cells , were determined at days 1 and 3 of treatment as well as 2 and 7 days after the end of treatment . Of all compartments ,  azithromycin concentrations were highest in white blood cells , attesting for intracellular accumulation . However ,  azithromycin concentrations in both soft tissues were markedly lower than in plasma both during and after treatment . Calculation of the area under the concentration-time curve from 0 to 24 h (AUC0–24)/MIC90 ratios for selected pathogens suggests that  azithromycin concentrations measured in the present study are subinhibitory at all time points in both soft tissues and at the large majority of observed time points in plasma . Hence , it might be speculated that azithromycin 's clinical efficacy relies not only on elevated intracellular concentrations but possibly also on its known pleotropic effects , including immunomodulation and influence on bacterial virulence factors . However , prolonged subinhibitory  azithromycin  concentrations at the target site , as observed in the present study , might favor the emergence of bacterial resistance and should therefore be considered with concern . In conclusion , this study has added important information to the pharmacokinetic profile of the widely used antibiotic drug azithromycin and evidentiates the need for further research on its potential for induction of bacterial resistance Introduction : This study was conducted to evaluate the efficacy of tigecycline ( TGC ) versus levofloxacin ( LEV ) in hospitalized patients with community-acquired pneumonia ( CAP ) using pooled data and to perform exploratory analyses of risk factors associated with poor outcome . Material s and Methodology : Pooled analyses of 2 phase 3 studies in patients r and omized to  intravenous ( IV ) TGC ( 100 mg , then 50 mg q12h ) or IV LEV ( 500 mg q24h or q12h ) . Clinical responses at test of cure visit for the clinical ly evaluable ( CE ) and clinical modified intention to treat population s were assessed for patients with risk factors including aged ≥65 years , prior antibiotic failure , bacteremia , multilobar disease , chronic obstructive pulmonary disease , alcohol abuse , altered mental status , hypoxemia , renal insufficiency , diabetes mellitus , white blood cell count > 30 x 109/L or < 4 x 109/L , CURB-65 score ≥2 , Fine score category of III to V and at least 2 clinical instability criteria on physical examination . Results : In the CE population of 574 patients  , overall cure rates were similar : TGC ( 253/282 , 89.7 % ) ; LEV ( 252/292 , 86.3 % ) . For all but one risk factor , cure rates  for TGC were similar to or higher than those for LEV . For individual risk factors , the greatest difference between treatment groups was observed in patients with diabetes mellitus ( difference of 22.9 for TGC versus LEV ; 95 % confidence interval , 4.8 - 39.9 ) . Conclusions : TGC  achieved cure rates similar to those of LEV in hospitalized patients with CAP . For patients with risk factors , TGC provided generally favorable clinical outcomes Background Viral respiratory infections are common worldwide and range from completely benign disease to life-threatening illness . Symptoms can be unspecific , and an etiologic diagnosis is rarely established because of a lack of suitable diagnostic tools . Improper use of antibiotics is common in this setting , which is detrimental in light of the development of bacterial resistance . It has been suggested that the use of diagnostic tests could reduce antibiotic prescription rates . The objective of this study was to evaluate whether access to a multiplex polymerase chain reaction ( PCR ) assay panel for etiologic diagnosis of acute respiratory tract infections ( ARTIs ) would have an impact on antibiotic prescription rate in primary care clinical setting s. Methods Adult patients with symptoms of ARTI were prospect ively included . Nasopharyngeal and throat swabs were analysed by using a multiplex real-time PCR method targeting thirteen viruses and two bacteria . Patients were recruited at 12 outpatient units from October 2006 through April 2009 , and sample s were collected on the day of inclusion ( initial visit ) and after 10 days ( follow-up visit ) . Patients were r and omised in an open-label treatment protocol to receive a rapid or delayed result ( on the following day or after eight to twelve days ) . The primary outcome measure was the antibiotic prescription rate at the initial visit , and the secondary outcome was the total antibiotic prescription rate during the study period . Results A total sample of 447 patients was r and omised . Forty-one were excluded , leaving 406 patients for analysis . In the group of patients r and omised for a rapid result , 4.5 % ( 9 of 202 ) of patients received  antibiotics  at the initial visit , compared to 12.3 % ( 25 of 204 ) ( P = 0.005 ) of patients in the delayed result group . At follow-up , there was no significant difference between the groups : 13.9 % ( 28 of 202 ) in the rapid result group and 17.2 % ( 35 of 204 ) in the delayed result group ( P = 0.359 ) , respectively . Conclusions Access to a rapid method for etiologic diagnosis of ARTIs may reduce antibiotic prescription rates at the initial visit in an outpatient setting . To sustain this effect , however , it seems necessary to better define how to follow and manage the patient according to the result of the test , which warrants further investigation . Trial registration Clinical Trials.gov identifier : NCT01133782 STUDY OBJECTIVE Comparison of efficacy and safety of sparfloxacin ( Spfx ) vs roxithromycin ( ROXI ) for treatment of community-acquired pneumonia ( CAP ) . DESIGN Multicenter , double-blind , r and omized study . SETTING Twenty-three university and community hospitals in Sc and inavia . PATIENTS Three hundred four adults ( > or = 18 years of age ) with CAP treated as out patients ( 25 % ) or in patients ( 75 % ) . INTERVENTIONS R and omization 1:1 to Spfx , 400 mg on day 1 , then 200 mg once daily , or ROXI , 150 mg twice daily , 10 to 14 days . Safety and efficacy analyses in intention-to-treat ( ITT ) and evaluable population s. RESULTS Three hundred three of 304 patients were included in the ITT and safety analyses and 260 ( 86 % ) were evaluable at the end of follow-up . Streptococcus pneumoniae was the cause of pneumonia in 62 ( 20 % ) patients ( 11 with bacteremia ) , Chlamydia pneumoniae in 40 ( 13 % ) , and Mycoplasma pneumoniae in 38 ( 13 % ) patients . The success rates for Spfx and ROXI at the end of follow-up were 82 % and 72 % , respectively , in the ITT population , and 94 % and 79 % , respectively , in the evaluable population . The odds ratio Spfx/ROXI for success was 4.5 ( 95 % confidence interval , 1.9 , 10.8 ) for the evaluable population . Both drugs were , overall , equally safe . GI symptoms were the most common adverse experiences in both groups . Prolongation of QTc , without clinical symptoms , was seen in 3 % of Spfx patients and in 1 % of ROXI patients , and photosensitivity , mostly mild to moderate , was seen in 5 % of the Spfx group . CONCLUSIONS Oral treatment with Spfx was superior to ROXI for the treatment of moderately severe CAP . Spfx was effective for all isolated pathogens , including S pneumoniae , and may be an alternative for empiric treatment of CAP , especially in areas with a high incidence of beta-lactam-resistant pneumococci ABSTRACT In looking for outcome differences beyond rates of cure , we prospect ively compared the symptom resolution , side effects , and processes of care between the use of clarithromycin and gatifloxacin for the treatment of radiographically confirmed community-acquired pneumonia . We conducted a multicenter , r and omized , open-label study comparing gatifloxacin monotherapy to clarithromycin alone or combined with ceftriaxone for patients with multiple risk factors . We measured the return to usual activities and symptoms over seven interviews ending 42 days after r and omization . Admission and hospital discharge decision support were provided to treating physicians . We enrolled 266 patients over the age of 18 years between September 2000 and June 2003 . The groups were similar in age and gender , with a mean age of 53.5 ± 19.4 years , and were 54 % female . Patient severity as determined by the number of risk factors and the Pneumonia Severity Index was similar between groups ; 95 % of the patients were low risk . A total of 91 % of patients completed at least five of seven symptom interviews . In the clarithromycin study arm , 64 % received concomitant therapy with ceftriaxone . We found no significant difference in return to usual activities , pneumonia-specific symptom scores , and 12-item short-form health survey scores . Individual symptom scores were similar except for bad taste and injection site soreness , which were higher in clarithromycin patients . The rates of hospital admission and length of stay were similar . The cost of antibiotic was higher in the clarithromycin group : $ 257 versus $ 110 for gatifloxacin . We found that gatifloxacin monotherapy is similar to clarithromycin given with or without ceftriaxone for the treatment of community-acquired pneumonia , except that antibiotic cost , bad taste , and injection site soreness favor the use of gatifloxacin BACKGROUND Treatment guidelines for community-acquired pneumonia ( CAP ) generally include use of a macrolide , a fluoroquinolone , or doxycycline , although there is some debate concerning the use of a fluoroquinolone . OBJECTIVE The efficacy and tolerability of a new once-daily , extended-release ( ER ) formulation of clarithromycin were compared with those of a fluoroquinolone , trovafloxacin , in the 
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However , we did not find any studies of antibiotics versus placebo .
Overall , there was no significant difference in the efficacy of the various antibiotics .
Though the majority of adverse events were similar between all antibiotics , nemonoxacin demonstrated higher gastrointestinal and nervous system adverse events when compared to levofloxacin , while cethromycin demonstrated significantly more nervous system side effects , especially dysgeusia , when compared to clarithromycin .
Similarly , high-dose amoxicillin ( 1 g three times a day ) was associated with higher incidence of gastritis and diarrhoea compared to clarithromycin , azithromycin and levofloxacin .
Individual study results do not reveal significant differences in efficacy between various antibiotics and antibiotic groups .