Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Three-weekly doses of azithromycin for Indigenous infants hospitalized with bronchiolitis: a multicentre, randomized, placebo-controlled trial

McCallum, Gabrielle B., Morris, Peter S., Grimwood, Keith, MacLennan, Carolyn, White, Andrew V., Chatfield, Mark D., Sloots, Theo P., Mackay, Ian M., Smith-Vaughan, Heidi C., McKay, Clare C., Versteegh, Lesley A., Jacobsen, Nerida, Mobberley, Charmaine, Byrnes, Catherine A. and Chang, Anne B. (2015). Three-weekly doses of azithromycin for Indigenous infants hospitalized with bronchiolitis: a multicentre, randomized, placebo-controlled trial. Frontiers in Pediatrics,3(Article No. 32).

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 4
Google Scholar Search Google Scholar
Attached Files (Some files may be inaccessible until you login with your CDU eSpace credentials)
Name Description MIMEType Size Downloads
Download this reading McCallum_59137.pdf Published version application/pdf 724.26KB 5
Reading the attached file works best in Firefox, Chrome and IE 9 or later.

IRMA ID 11381xPUB66
Title Three-weekly doses of azithromycin for Indigenous infants hospitalized with bronchiolitis: a multicentre, randomized, placebo-controlled trial
Author McCallum, Gabrielle B.
Morris, Peter S.
Grimwood, Keith
MacLennan, Carolyn
White, Andrew V.
Chatfield, Mark D.
Sloots, Theo P.
Mackay, Ian M.
Smith-Vaughan, Heidi C.
McKay, Clare C.
Versteegh, Lesley A.
Jacobsen, Nerida
Mobberley, Charmaine
Byrnes, Catherine A.
Chang, Anne B.
Journal Name Frontiers in Pediatrics
Publication Date 2015
Volume Number 3
Issue Number Article No. 32
ISSN 2296-2360   (check CDU catalogue  open catalogue search in new window)
Total Pages 9
Place of Publication Switzerland
Publisher Frontiers Research Foundation
HERDC Category C1 - Journal Article (DIISR)
Abstract 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 hospitalization period. In an international, double-blind randomized controlled trial, we determined if 3 weeks of azithromycin improved clinical outcomes in Indigenous infants hospitalized with bronchiolitis.

Methods: Infants aged ≤24 months were enrolled from three centers and randomized to receive three once-weekly doses of either azithromycin (30 mg/kg) or placebo. Nasopharyngeal swabs were collected at baseline and 48 h later. Primary endpoints were hospital length of stay (LOS) and duration of oxygen supplementation monitored every 12 h until judged ready for discharge. Secondary outcomes were: day-21 symptom/signs, respiratory rehospitalizations within 6 months post-discharge and impact upon nasopharyngeal bacteria and virus shedding at 48 h.

Results:
Two hundred nineteen infants were randomized (n = 106 azithromycin, n = 113 placebo). No significant between-group differences were found for LOS (median 54 h for each group, difference = 0 h, 95% CI: −6, 8; p = 0.8), time receiving oxygen (azithromycin = 40 h, placebo = 35 h, group difference = 5 h, 95% CI: −8, 11; p = 0.7), day-21 symptom/signs, or rehospitalization within 6 months (azithromycin n = 31, placebo n = 25 infants, p = 0.2). Azithromycin reduced nasopharyngeal bacterial carriage (between-group difference 0.4 bacteria/child, 95% CI: 0.2, 0.6; p < 0.001), but had no significant effect upon virus detection rates.

Conclusion: 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.

Clinical trial registration:
The trial was registered with the Australian and New Zealand Clinical Trials Register: Clinical trials number: ACTRN1261000036099.
Keywords Bronchiolitis
Indigenous
Viruses
Bacteria
Respiratory syncytial virus
Macrolides
Azithromycin
Randomized controlled trial
DOI http://dx.doi.org/10.3389/fped.2015.00032   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


© copyright

Every reasonable effort has been made to ensure that permission has been obtained for items included in CDU eSpace. If you believe that your rights have been infringed by this repository, please contact digitisation@cdu.edu.au.

 
Versions
Version Filter Type
Access Statistics: 10 Abstract Views, 5 File Downloads  -  Detailed Statistics
Created: Tue, 26 Jul 2016, 12:47:40 CST