Which antibiotic class is commonly used to treat Legionella infections?

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Legionella infections require antibiotics that reach intracellular bacteria, because Legionella replicates inside macrophages in the lungs. Macrolides and fluoroquinolones penetrate cells well and achieve high intracellular concentrations, making them the standard first-line choices for treating Legionella. Beta-lactams have limited intracellular activity and are not reliably effective against this organism. Aminoglycosides likewise have poor intracellular penetration and aren’t preferred for Legionella. While tetracyclines can be used in some cases, macrolides and fluoroquinolones are favored due to their superior intracellular activity and good lung tissue distribution.