What is the treatment of choice for Legionella pneumophila infections?

The treatment of choice for Legionella pneumophila infections is a macrolide antibiotic, with erythromycin being a well-known option historically used in the treatment of such infections. Legionella pneumophila is a bacterium that causes Legionnaires' disease, a severe form of pneumonia. Macrolides, including erythromycin, are effective against Legionella because they have good intracellular penetration, which is essential since this organism often replicates within macrophages.

While other antibiotics such as tetracyclines (e.g., doxycycline) and fluoroquinolones (e.g., levofloxacin) can also be effective against Legionella, erythromycin has been a classic treatment choice since it was first established as effective for this pathogen. Its ability to inhibit protein synthesis is crucial for targeting this intracellular organism.

In this context, options such as spironolactone, chloroquine, and dantrolene are not relevant. Spironolactone is a diuretic used primarily for conditions such as hypertension and heart failure. Chloroquine is an antimalarial drug that has no significant role in Legionella infections. Dantrolene is used primarily as a muscle relaxant in conditions like malignant hyperthermia and is not indicated