Treatment strategies for Legionella infection

M. Luisa Pedro-Botet, Victor L. Yu

Research output: Contribution to journalReview articleResearchpeer-review

55 Citations (Scopus)


Given the nonspecific clinical manifestations of Legionnaires' disease and the high mortality of untreated Legionnaires' disease, we recommend routine use of Legionella testing, especially the Legionella urinary antigen test, for all patients with community-acquired pneumonia. This includes patients with ambulatory pneumonia and hospitalized children. Legionella cultures should be more widely available, especially in hospitals where the drinking water is colonized with Legionella. Azithromycin or levofloxacin can be considered as first-line therapy. Other antibiotics including tetracyclines, tigecycline, other fluoroquinolones and other macrolides (especially clarithromycin) are also effective. The clinical response of quinolones may be somewhat more favorable compared to macrolides, but the outcome is similar. If the Legionnaires' disease is hospital-acquired, culturing of the hospital drinking water for Legionella is indicated. © 2009 Informa UK Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)1109-1121
JournalExpert Opinion on Pharmacotherapy
Issue number7
Publication statusPublished - 1 May 2009


  • Animal model
  • Azithromycin
  • Clarithromycin
  • Community-acquired pneumonia
  • Erythromycin
  • Hospital-acquired pneumonia
  • Legionella
  • Legionella pneumophila
  • Legionnaires' disease
  • Levofloxacin
  • Macrolides
  • Quinolones
  • Rifampin
  • Tetracyclines


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