Comparison of azithromycin and doxycycline for the treatment of Chlamydia psittaci pneumonia
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background and Objective Chlamydia psittaci pneumonia (CPP) has received increasing clinical attention worldwide in recent years. Although doxycycline is the recommended first-line therapy and macrolides serve as alternatives, no studies have directly compared their clinical efficacy in the general adult population. This study aimed to compare clinical outcomes between doxycycline and azithromycin in adult patients with CPP. Methods This retrospective single-center cohort study included 57 adult patients with CPP at Peking University Third Hospital from 2021 to 2025, of whom 31 received doxycycline and 26 received azithromycin. Demographic characteristics, laboratory findings, and clinical outcomes were compared between the two groups. Results Baseline characteristics, including comorbidities and laboratory findings, were comparable between groups. Respiratory support requirements and glucocorticoid use were similar (all P > 0.05). A numerical imbalance in Intensive Care Unit (ICU) admission rate was observed, with 16.1% in the doxycycline group and 0% in the azithromycin group ( P = 0.056); this difference likely reflects treatment-selection bias given the small sample size. No significant differences were observed in 28-day discharge rate (96.8% vs. 100%), mortality (3.2% vs. 0%), median length of hospital stay (6 vs. 6 days, P = 0.691), or time to defervescence (2 vs. 2 days, P = 0.436). Conclusion No statistically significant differences were observed in measured short-term clinical outcomes between doxycycline and azithromycin for CPP. Both may be reasonable therapeutic options, but findings should be interpreted cautiously given limited statistical power and potential confounding by indication, especially where drug availability or susceptibility data are limited.
Source: Frontiers in Pharmacology
Institution: Peking University Third Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Award: G45388773
OpenAlex ID: W7222579866