{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:08:51Z","timestamp":1790870931924,"version":"4.1.0"},"reference-count":20,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":119,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["IDCases"],"published-print":{"date-parts":[[2025]]},"DOI":"10.1016\/j.idcr.2025.e02242","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T06:19:58Z","timestamp":1746080398000},"page":"e02242","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Severe Legionnaires\u2019 disease refractory to azithromycin: Are quinolones superior to macrolides?"],"prefix":"10.1016","volume":"40","author":[{"given":"Luqman","family":"Croal-Abrahams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-8762","authenticated-orcid":false,"given":"Folasade","family":"Arinze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.idcr.2025.e02242_bib1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"issue":"42","key":"10.1016\/j.idcr.2025.e02242_bib2","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.15585\/mmwr.mm6442a2","article-title":"Active bacterial core surveillance for legionellosis \u2013 United States, 2011\u20132013","volume":"64","author":"Dooling","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"1","key":"10.1016\/j.idcr.2025.e02242_bib3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/MD.0b013e31827f6104","article-title":"Community-acquired Legionella pneumophila pneumonia: a single-center experience with 214 hospitalized sporadic cases over 15 years","volume":"92","author":"Viasus","year":"2013","journal-title":"Medicine"},{"issue":"1","key":"10.1016\/j.idcr.2025.e02242_bib4","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S1369-5274(99)80005-8","article-title":"Cell biology of Legionella pneumophila","volume":"2","author":"Vogel","year":"1999","journal-title":"Curr Opin Microbiol"},{"issue":"6","key":"10.1016\/j.idcr.2025.e02242_bib5","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1093\/ajcp\/76.6.816","article-title":"Legionnaires' disease in Vermont. 1972\u20131976","volume":"76","author":"Gerber","year":"1981","journal-title":"Am J Clin Pathol"},{"issue":"6","key":"10.1016\/j.idcr.2025.e02242_bib6","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1093\/jac\/43.6.747","article-title":"The treatment of Legionnaires\u2019 disease","volume":"48","author":"Dedicoat","year":"1999","journal-title":"J Antimicrob Chemother"},{"issue":"7","key":"10.1016\/j.idcr.2025.e02242_bib7","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1517\/14656560902900820","article-title":"Treatment strategies for Legionella infection","volume":"10","author":"Pedro-Botet","year":"2009","journal-title":"Expert Opin Pharm"},{"issue":"11","key":"10.1016\/j.idcr.2025.e02242_bib8","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1093\/cid\/ciaa441","article-title":"Are fluoroquinolones or macrolides better for treating Legionella pneumonia? A systematic review and meta-analysis","volume":"72","author":"Jasper","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"3","key":"10.1016\/j.idcr.2025.e02242_bib9","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.jiac.2020.10.002","article-title":"Meta-analysis of fluoroquinolones versus macrolides for treatment of legionella pneumonia","volume":"27","author":"Kato","year":"2021","journal-title":"J Infect Chemother"},{"issue":"3","key":"10.1016\/j.idcr.2025.e02242_bib10","doi-asserted-by":"crossref","first-page":"e02188","DOI":"10.1128\/AAC.02188-16","article-title":"Ribosomal mutations conferring macrolide resistance in Legionella pneumophila","volume":"61","author":"Descours","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"issue":"1","key":"10.1016\/j.idcr.2025.e02242_bib11","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0732-8893(99)00095-4","article-title":"Susceptibility of Legionella species to five antibiotics and development of resistance by exposure to erythromycin, ciprofloxacin, and rifampicin","volume":"36","author":"Nielsen","year":"2000","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"16","key":"10.1016\/j.idcr.2025.e02242_bib12","doi-asserted-by":"crossref","first-page":"5809","DOI":"10.3390\/ijerph17165809","article-title":"Antibiotic resistance of Legionella pneumophila in clinical and water isolates\u2013a systematic review","volume":"17","author":"Pappa","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"7","key":"10.1016\/j.idcr.2025.e02242_bib13","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American thoracic society and Infectious diseases society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"10.1016\/j.idcr.2025.e02242_bib14","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1086\/428059","article-title":"Clinical outcomes for hospitalized patients with Legionella pneumonia in the antigenuria era: the influence of levofloxacin therapy","volume":"40","author":"Mykietiuk","year":"2005","journal-title":"Clin Infect Dis"},{"issue":"3","key":"10.1016\/j.idcr.2025.e02242_bib15","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1378\/chest.128.3.1401","article-title":"Fluoroquinolones vs macrolides in the treatment of Legionnaires disease","volume":"128","author":"Sabri\u00e0","year":"2005","journal-title":"Chest"},{"issue":"6","key":"10.1016\/j.idcr.2025.e02242_bib16","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1086\/428049","article-title":"Antimicrobial chemotherapy for Legionnaires disease: levofloxacin versus macrolides","volume":"40","author":"Bl\u00e1zquez Garrido","year":"2005","journal-title":"Clin Infect Dis"},{"issue":"9","key":"10.1016\/j.idcr.2025.e02242_bib17","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1093\/jac\/dku159","article-title":"Quinolones versus macrolides in the treatment of legionellosis: a systematic review and meta-analysis","volume":"69","author":"Burdet","year":"2014","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"10.1016\/j.idcr.2025.e02242_bib18","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s40121-022-00635-7","article-title":"Legionnaires' disease: update on diagnosis and treatment","volume":"11","author":"Viasus","year":"2022","journal-title":"Infect Dis Ther"},{"issue":"1","key":"10.1016\/j.idcr.2025.e02242_bib19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.idc.2016.10.009","article-title":"Severe pneumonia caused by Legionella pneumophila: differential diagnosis and therapeutic considerations","volume":"31","author":"Chahin","year":"2017","journal-title":"Infect Dis Clin N Am"},{"key":"10.1016\/j.idcr.2025.e02242_bib20","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ejim.2023.09.013","article-title":"Legionella pneumonia in hospitalized adults with respiratory failure: quinolones or macrolides?","volume":"120","author":"Ruiz-Spinelli","year":"2024","journal-title":"Eur J Intern Med"}],"container-title":["IDCases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2214250925000988?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2214250925000988?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T11:24:27Z","timestamp":1749554667000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2214250925000988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":20,"alternative-id":["S2214250925000988"],"URL":"https:\/\/doi.org\/10.1016\/j.idcr.2025.e02242","relation":{},"ISSN":["2214-2509"],"issn-type":[{"value":"2214-2509","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Severe Legionnaires\u2019 disease refractory to azithromycin: Are quinolones superior to macrolides?","name":"articletitle","label":"Article Title"},{"value":"IDCases","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.idcr.2025.e02242","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"e02242"}}