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Randomised Controlled Trial of Azithromycin to Reduce the Morbidity of Severe Bronchiolitis in Young Indigenous Children
This research investigated bronchiolitis in young Indigenous children and the clinical effectiveness of the drug azithromycin compared with a placebo in treating the illness. In addition to this primary investigation the research also looked at other issues relating to acute lower respiratory tract infections in Indigenous children, specifically:
- determining the effectiveness of treatment on readmissions to hospital within six months
- examining if macrolide* resistant respiratory pathogens (germs) found in swabs taken from the nasal part of the throat influence the severity of the illness
- assessing the short-term impact of azithromycin on macrolide resistant patterns of respiratory germs in the nasal part of the throat
- describing the number of cases of specific respiratory diseases (mycoplasma pneumoniae and chlamydia) present in this population at a certain time and the diversity of the disease using specific sensitive molecular diagnostic techniques.
The research found that despite reducing nasopharyngeal bacterial carriage, three large once-weekly doses of azithromycin did not confer any benefit over placebo during the bronchiolitis illness or 6 months post hospitalization. Azithromycin should not be used routinely to treat infants hospitalized with bronchiolitis.
*Macrolide is one in a class of antibiotics that inhibits the growth of bacteria and is often prescribed to treat common bacterial infections.
Abstract adapted from Menzies School of Health Research
Menzies School of Health Research
McCallum GB, Chatfield MD, Morris PS, Chang AB (2015)
Risk factors for adverse outcomes of Indigenous infants hospitalized with bronchiolitis.
Pediatric Pulmonology; Early view(http://dx.doi.org/10.1002/ppul.23342):
McCallum GB, Morris PS, Wilson CC, Versteegh LA, Ward LM, Chatfield MD, Chang AB (2013)
Severity scoring systems: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis?.
Pediatric Pulmonology; 48(8): 797–803
McCallum GB, Morris PS, Grimwood K, Maclennan C, White AV, Chatfield MD, Sloots TP, Mackay IM, Smith-Vaughan H, McKay CC, Versteegh LA, Jacobsen N, Mobberley C, Byrnes CA, Chang AB (2015)
Three-weekly doses of azithromycin for indigenous infants hospitalized with bronchiolitis: a multicentre, randomized, placebo-controlled trial.
Frontiers in Pediatrics; 3(32): 1-9
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