Comparison of azithromycin and doxycycline for the treatment of Chlamydia psittaci pneumonia
- 1Department of Infectious Diseases, Peking University Third Hospital
- 2Department of Respiratory and Critical Care Medicine, Peking University Third Hospital
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.
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BibTeX
@article{cheng2026comparison,
title = {{Comparison of azithromycin and doxycycline for the treatment of Chlamydia psittaci pneumonia}},
author = {Ran Cheng and Zhonghua Deng and Fei Lin and Biying Zhang and Jingjin Liang and Ming Lu},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1900992},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1900992/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparison of azithromycin and doxycycline for the treatment of Chlamydia psittaci pneumonia
AU - Ran Cheng
AU - Zhonghua Deng
AU - Fei Lin
AU - Biying Zhang
AU - Jingjin Liang
AU - Ming Lu
PY - 2026
DA - 2026/10/16
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1900992
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1900992/full
AB - 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.
SN - 1663-9812
ER -