Effect of clarithromycin in patients with suspected Gram-negative sepsis: results of a randomized controlled trial

Background: A previous randomized study showed that clarithromycin decreases the risk of death due to ventila-tor-associated pneumonia and shortens the time until infection resolution. The efficacy of clarithromycin was tested in a larger population with sepsis. Methods: Six hundredpatientswith systemic inflammatory response syndromedue toacutepyelonephritis, acute intra-abdominal infections or primary Gram-negative bacteraemia were enrolled in a double-blind, randomized, multicentre trial. Clarithromycin (1 g) was administered intravenously once daily for 4 days consecutively in 302 patients; another 298 patientswere treatedwith placebo. Mortality was the primary outcome; resolution of infec-tion and hospitalization costs were the secondary outcomes