Three-weekly doses of azithromycin for Indigenous infants hospitalised with bronchiolitis: A multicentre, randomised, placebo-controlled trial

Autor: Gabrielle Britt McCallum, Peter S Morris, Keith eGrimwood, Carolyn eMaclennan, Andrew V White, Mark D Chatfield, Theo P Sloots, Ian M Mackay, Heidi eSmith-Vaughan, Clare C Mckay, Lesley A Versteegh, Nerida eJacobsen, Charmaine eMobberley, Catherine Ann Byrnes, Anne B Chang
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Frontiers in Pediatrics, Vol 3 (2015)
Druh dokumentu: article
ISSN: 2296-2360
DOI: 10.3389/fped.2015.00032
Popis: Background Bronchiolitis is a major health burden in infants globally, particularly among Indigenous populations. It is unknown if 3-weeks of azithromycin improve clinical outcomes beyond the hospitalisation period. In an international, double-blind randomised controlled trial, we determined if 3-weeks of azithromycin, improved clinical outcomes in Indigenous infants hospitalised with bronchiolitis. Methods Infants aged ≤24-months were enrolled from three centres and randomised to receive three once-weekly doses of either azithromycin (30mg/kg) or placebo. Nasopharyngeal swabs were collected at baseline and 48-hours later. Primary endpoints were hospital length of stay (LOS) and duration of oxygen supplementation monitored every 12-hours until judged ready for discharge. Secondary outcomes were: day-21 symptom/signs, respiratory rehospitalisations within 6-months post-discharge and impact upon nasopharyngeal bacteria and virus shedding at 48-hours. Results Two-hundred-and-nineteen infants were randomised (n=106 azithromycin, n=113 placebo). No significant between-group differences were found for LOS (median 54-hours for each group, difference=0-hours, 95%CI: -6, 8; p=0.8), time receiving oxygen (azithromycin=40-hours, placebo=35-hours, group difference=5-hours, 95%CI: -8, 11; p=0.7), day-21 symptom/signs or rehospitalisation within 6-months (azithromycin n=31, placebo=25 infants, p=0.2). Azithromycin reduced nasopharyngeal bacterial carriage (between-group difference 0.4 bacteria/child, 95%CI: 0.2, 0.6; p
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