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Macrolides or fluoroquinolones as enteral antibiotic therapy for non-ICU legionellosis

  • Renaud ScusselEmail author
  • Karine Risso
  • Elisa Demonchy
  • Céline Michelangeli
  • Pierre-Marie Roger
While legionellosis incidence has increased in Europe, up to 21% from 2012 to 2016 [ 1], the choice between fluoroquinolones or macrolides as first-line antibiotic therapy remains controversial. Indeed, a meta-analysis of 2014 [ 2] included 12 studies with some favoring fluoroquinolones and some macrolides, with a 0.5 mortality odds ratio for fluoroquinolones, but it was not significant. Length of stay (LOS) was shorter. In a recent study [ 3], which is the biggest series (446 legionellosis), no difference was found for mortality, LOS, and duration of fever. Herein we report the results of our cohort of patients presenting with legionellosis treated according to our internal guideline advising enteral macrolide since April 2008. Roxithromycin was selected among macrolide, for which there is no parenteral form (Table  1).
Table 1

Comparison of patients according to antibiotic treatment for legionellosis



n = 55 (47%)


n = 39 (33%)


Other antibiotic therapies

n =...


Compliance with ethical standards

Conflict of interest



  1. 1.
    European Centre for Disease Prevention and Control, Legionnaires’ disease—Annual Epidemiological Report for 2016. Accessed 8 Aug 2018.
  2. 2.
    Burdet C, Lepeule R, Duval X, Caseris M, Rioux C, Lucet JC, Yazdanpanah Y. Quinolones versus macrolides in the treatment of legionellosis: a systematic review and meta-analysis. J Antimicrobial Chemother. 2014;69:2354–60.CrossRefGoogle Scholar
  3. 3.
    Garcia-Vidal C, Sanchez-Rodriguez I, Simonetti AF, et al. Levofloxacin versus azithromycin for treating legionella pneumonia: a propensity score analysis. Clin Microbiol Infect. 2017;23:653–8.CrossRefGoogle Scholar
  4. 4.
    Roger PM, Demonchy E, Risso K, et al. Medical table: a major tool for antimicrobial stewardship policy. Med Mal Infect. 2017;47:311–8.CrossRefGoogle Scholar
  5. 5.
    European Commission. Amending Decision 2002/253/EC laying down case definitions for reporting communicable diseasesto the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. OJ L 159, 18.6.2008, 2008. p. 46–90.  Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Renaud Scussel
    • 1
    Email author
  • Karine Risso
    • 1
  • Elisa Demonchy
    • 1
  • Céline Michelangeli
    • 1
  • Pierre-Marie Roger
    • 1
  1. 1.Infectiologie Centre Hospitalier Universitaire de NiceUniversité Côte d’AzurNiceFrance

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