The use of azithromycin early during an apparent respiratory tract illness (RTI) reduced the likelihood of severe lower respiratory tract illness (LRTI) among young children with histories of recurrent severe LRTIs when compared with placebo, according to a study of 607 children aged 12 through 71 months. Participants were randomized in a 1:1 ratio to receive either azithromycin (12 mg/kg once daily for 5 days) or matching placebo at the start of an RTI. Researchers found:
• A total of 937 treated RTIs were experienced by 443 children, including 92 severe LRTIs (azithromycin group, 35; placebo group, 57).
• Azithromycin significantly reduced the risk of progressing to severe LRTI relative to placebo (HR, 0.64).
• Induction of azithromycin-resistant organisms and adverse events were infrequent.
Citation: Bacharier LB, Guilbert TW, Mauger DT, et al. Early administration of azithromycin and prevention of severe lower respiratory tract illnesses in preschool children with a history of such illnesses: A randomized clinical trial. JAMA. 2015;314(19):2034-2044. doi: 10.1001/jama.2015.13896.
1. Ly NP, Gold DR, Weiss ST, Celedón JC. Recurrent wheeze in early childhood and asthma among children at risk for atopy. Pediatrics. 2006;117(6): e1132-e1138.
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