Effect of Long-Term Clarithromycin Therapy on Prevention of Pneumonia in Older Adults: A Randomized, Controlled Trial.

AimPneumonia in older adults is increasingly recognized as a healthcare issue in countries with an aging population. Long‐term macrolide therapy reduces exacerbations of chronic respiratory diseases, but its effects on the prevention of pneumonia have not been determined.MethodsWe carried out a randomized, controlled trial to test the effect of long‐term clarithromycin therapy on the prevention of pneumonia among older adults. People aged ≥65 years who had recovered from pneumonia within the previous 3 months were recruited and randomly allocated to a long‐term, low‐dose clarithromycin (CAM) therapy group (n = 13) or a control group (n = 15).ResultsBoth groups were followed up until recurrence of pneumonia. The median follow‐up period was 251 days (95% CI 171–330) in the CAM group and 132 days (95% CI 67–196) in the control group (P = 0.627). The recurrence rate of pneumonia was two out of 13 (15%) in the CAM group and five out of 15 (33%) in the control group (P = 0.268). The median time to recurrence of pneumonia was 315 days (95% CI 249–382) in the CAM group and 260 days (95% CI 184–335) in the control group (P = 0.260). None of the differences between groups were statistically significant.ConclusionsNo statistically significant suppressive effects of long‐term, low‐dose macrolide therapy on the development of pneumonia among older people were found in this small sample. A large‐scale, randomized, controlled study is required. Geriatr Gerontol Int 2019; 19: 1006–1009.